| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $54 | $85 | $116 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $102 | $143 | $184 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $72 | $120 | $145 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $98 | $124 | $150 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $49 | $72 | $96 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $65 | $122 | $150 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $68 | $106 | $150 |
| Group psychotherapy CPT 90853 • Mental Health | $16 | $47 | $77 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $3 | $4 | $4 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $98 | $110 | $123 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $30 | $55 | $80 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $93 | $120 | $134 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $264 | $314 | $367 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $304 | $367 | $429 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $75 | $99 | $111 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $53 | $125 | $161 |
| EMG needle each extremity complete CPT 95886 • Neurology | $35 | $66 | $97 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $45 | $65 | $89 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $22 | $69 | $111 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $78 | $101 | $134 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $48 | $133 | $175 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $190 | $254 | $285 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $31 | $55 | $71 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $30 | $52 | $75 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $112 | $132 | $164 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $120 | $149 | $188 |
| Office visit established patient minimal CPT 99211 • Office Visits | $16 | $25 | $30 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $23 | $36 | $55 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $30 | $40 | $61 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $30 | $68 | $110 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $30 | $75 | $121 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $30 | $85 | $170 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $87 | $128 | $170 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $19 | $111 | $198 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $33 | $81 | $129 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $30 | $70 | $129 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $30 | $79 | $129 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $30 | $71 | $129 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $76 | $112 | $130 |
| Consultation office low complexity CPT 99243 • Office Visits | $30 | $92 | $170 |
| Consultation office high complexity CPT 99245 • Office Visits | $140 | $216 | $255 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $417 | $509 | $601 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $24 | $27 | $30 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $781 | $781 | $781 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $163 | $180 | $197 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $30 | $601 | $1,047 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $337 | $434 | $483 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $199 | $312 | $425 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $493 | $493 | $493 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $30 | $195 | $360 |