| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $143 | $155 | $167 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $54 | $61 | $69 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $109 | $111 | $112 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $114 | $123 | $132 |
| Group psychotherapy CPT 90853 • Mental Health | $22 | $27 | $31 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $3 | $4 | $4 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $33 | $108 | $184 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $32 | $37 | $42 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $67 | $109 | $152 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $274 | $298 | $323 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $74 | $222 | $370 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $91 | $99 | $107 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $30 | $91 | $151 |
| EMG needle each extremity complete CPT 95886 • Neurology | $16 | $47 | $79 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $42 | $62 | $83 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $26 | $64 | $103 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $78 | $102 | $126 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $111 | $139 | $168 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $197 | $228 | $259 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $19 | $55 | $92 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $130 | $130 | $130 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $42 | $71 | $100 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $11 | $27 | $42 |
| Office visit established patient minimal CPT 99211 • Office Visits | $8 | $18 | $28 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $32 | $44 | $55 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $29 | $59 | $90 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $42 | $76 | $111 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $131 | $153 | $174 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $39 | $94 | $148 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $16 | $90 | $164 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $239 | $239 | $240 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $33 | $74 | $115 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $59 | $87 | $115 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $39 | $81 | $123 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $59 | $87 | $115 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $8 | $67 | $126 |
| Consultation office low complexity CPT 99243 • Office Visits | $42 | $77 | $113 |
| Consultation office high complexity CPT 99245 • Office Visits | $17 | $143 | $269 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $42 | $277 | $512 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $7 | $44 | $81 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,089 | $1,246 | $1,404 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $28 | $35 | $42 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,155 | $1,155 | $1,156 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $572 | $668 | $763 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $63 | $63 | $63 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $42 | $42 | $42 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $493 | $493 | $493 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $12 | $12 | $12 |
| Retinal detachment repair with vitrectomy CPT 67108 • Ophthalmology | $42 | $42 | $42 |
| Retinal photocoagulation treatment CPT 67210 • Ophthalmology | $92 | $354 | $615 |