| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $118 | $129 | $139 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $52 | $56 | $59 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $96 | $105 | $113 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $113 | $113 | $113 |
| Group psychotherapy CPT 90853 • Mental Health | $43 | $47 | $52 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $3 | $3 | $3 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $33 | $125 | $217 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $44 | $44 | $44 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $123 | $150 | $176 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $66 | $198 | $330 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $184 | $276 | $368 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $58 | $80 | $103 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $30 | $90 | $151 |
| EMG needle each extremity complete CPT 95886 • Neurology | $54 | $76 | $97 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $106 | $106 | $106 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $26 | $78 | $130 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $157 | $157 | $157 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $103 | $155 | $206 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $68 | $204 | $340 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $56 | $64 | $72 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $39 | $72 | $105 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $16 | $16 | $16 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $20 | $86 | $152 |
| Office visit established patient minimal CPT 99211 • Office Visits | $1 | $29 | $56 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $4 | $30 | $56 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $51 | $61 | $70 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $53 | $79 | $105 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $56 | $99 | $141 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $10 | $70 | $130 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $69 | $105 | $141 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $202 | $204 | $207 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $4 | $43 | $83 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $72 | $77 | $83 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $52 | $79 | $106 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $56 | $70 | $83 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $89 | $99 | $108 |
| Consultation office low complexity CPT 99243 • Office Visits | $124 | $124 | $124 |
| Consultation office high complexity CPT 99245 • Office Visits | $96 | $160 | $223 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $434 | $534 | $634 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $11 | $40 | $69 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $871 | $871 | $871 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $56 | $148 | $241 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $240 | $719 | $1,198 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $623 | $623 | $623 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $210 | $210 | $210 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $543 | $543 | $543 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $117 | $117 | $117 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $56 | $56 | $56 |
| Retinal detachment repair with vitrectomy CPT 67108 • Ophthalmology | $56 | $56 | $56 |
| Retinal photocoagulation treatment CPT 67210 • Ophthalmology | $703 | $703 | $704 |