| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $89 | $139 | $211 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $118 | $136 | $176 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $102 | $170 | $278 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $177 | $231 | $339 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $162 | $162 | $162 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $87 | $103 | $122 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $91 | $148 | $271 |
| Group psychotherapy CPT 90853 • Mental Health | $38 | $42 | $44 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $7 | $13 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $70 | $297 | $511 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $101 | $141 | $181 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $90 | $157 | $264 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $56 | $128 | $253 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $80 | $353 | $863 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $114 | $114 | $114 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $42 | $77 | $128 |
| EMG needle each extremity complete CPT 95886 • Neurology | $49 | $80 | $128 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $31 | $60 | $79 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $38 | $90 | $164 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $46 | $103 | $197 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $58 | $154 | $259 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $141 | $265 | $412 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $41 | $77 | $100 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $82 | $107 | $124 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $128 | $189 | $258 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $180 | $231 | $282 |
| Office visit established patient minimal CPT 99211 • Office Visits | $19 | $25 | $31 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $49 | $64 | $92 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $59 | $69 | $88 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $94 | $166 | $224 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $118 | $164 | $224 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $108 | $122 | $137 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $159 | $200 | $285 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $159 | $264 | $401 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $50 | $70 | $112 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $84 | $95 | $112 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $112 | $150 | $216 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $84 | $96 | $112 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $102 | $143 | $211 |
| Consultation office low complexity CPT 99243 • Office Visits | $62 | $128 | $215 |
| Consultation office high complexity CPT 99245 • Office Visits | $182 | $238 | $303 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $479 | $878 | $1,678 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $39 | $53 | $81 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,174 | $1,257 | $1,424 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $205 | $509 | $1,118 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,320 | $1,320 | $1,320 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $2,076 | $2,076 | $2,076 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $237 | $331 | $453 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $744 | $903 | $1,221 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $543 | $988 | $2,135 |