| Psychotherapy 60 minutes CPT 90837 • Mental Health | $190 | $241 | $320 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $163 | $163 | $163 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $196 | $196 | $196 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $95 | $95 | $95 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $152 | $211 | $240 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $158 | $213 | $240 |
| Group psychotherapy CPT 90853 • Mental Health | $39 | $39 | $39 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $7 | $8 | $8 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $252 | $252 | $252 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $194 | $206 | $218 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $193 | $193 | $193 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $413 | $545 | $678 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $96 | $524 | $908 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $173 | $173 | $173 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $122 | $122 | $122 |
| EMG needle each extremity complete CPT 95886 • Neurology | $131 | $148 | $166 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $78 | $78 | $78 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $70 | $70 | $70 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $117 | $177 | $236 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $156 | $156 | $156 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $278 | $389 | $501 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $85 | $111 | $147 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $110 | $173 | $227 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $188 | $242 | $296 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $294 | $335 | $372 |
| Office visit established patient minimal CPT 99211 • Office Visits | $13 | $31 | $48 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $36 | $69 | $115 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $103 | $153 | $186 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $113 | $166 | $214 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $205 | $262 | $370 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $133 | $206 | $273 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $197 | $223 | $273 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $48 | $230 | $354 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $57 | $115 | $207 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $104 | $160 | $207 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $150 | $207 | $243 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $104 | $118 | $131 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $154 | $160 | $169 |
| Consultation office low complexity CPT 99243 • Office Visits | $178 | $178 | $178 |
| Consultation office high complexity CPT 99245 • Office Visits | $324 | $324 | $324 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $992 | $992 | $992 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $112 | $112 | $112 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,898 | $1,898 | $1,898 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $551 | $551 | $551 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,949 | $1,949 | $1,949 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $1,024 | $1,024 | $1,024 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $386 | $386 | $386 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $1,312 | $1,312 | $1,312 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $1,053 | $1,053 | $1,053 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $167 | $167 | $167 |