| Psychotherapy 60 minutes CPT 90837 • Mental Health | $230 | $245 | $260 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $225 | $225 | $225 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $270 | $294 | $318 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $128 | $128 | $128 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $203 | $206 | $208 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $217 | $226 | $235 |
| Group psychotherapy CPT 90853 • Mental Health | $51 | $52 | $52 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $11 | $11 | $11 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $102 | $134 | $165 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $273 | $273 | $273 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $268 | $268 | $268 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $418 | $508 | $597 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $118 | $310 | $501 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $243 | $243 | $243 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $343 | $343 | $343 |
| EMG needle each extremity complete CPT 95886 • Neurology | $182 | $185 | $188 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $82 | $143 | $204 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $137 | $213 | $252 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $125 | $129 | $133 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $166 | $282 | $398 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $212 | $212 | $212 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $105 | $128 | $150 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $151 | $185 | $219 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $102 | $233 | $334 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $102 | $287 | $410 |
| Office visit established patient minimal CPT 99211 • Office Visits | $19 | $41 | $62 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $66 | $76 | $87 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $107 | $127 | $147 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $102 | $140 | $216 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $213 | $220 | $227 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $166 | $187 | $209 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $197 | $239 | $281 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $102 | $269 | $414 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $81 | $87 | $94 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $94 | $120 | $147 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $149 | $181 | $212 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $94 | $120 | $147 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $154 | $200 | $229 |
| Consultation office low complexity CPT 99243 • Office Visits | $214 | $260 | $318 |
| Consultation office high complexity CPT 99245 • Office Visits | $102 | $290 | $453 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $1,226 | $1,226 | $1,226 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $108 | $108 | $108 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $2,408 | $2,408 | $2,408 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $548 | $548 | $548 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,959 | $1,959 | $1,959 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $1,298 | $1,298 | $1,298 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $595 | $595 | $595 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $1,614 | $1,614 | $1,614 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $1,296 | $1,296 | $1,296 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $204 | $204 | $204 |