| Psychotherapy 60 minutes CPT 90837 • Mental Health | $85 | $135 | $184 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $96 | $116 | $144 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $99 | $138 | $176 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $5 | $51 | $85 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $63 | $99 | $134 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $91 | $130 | $150 |
| Group psychotherapy CPT 90853 • Mental Health | $40 | $46 | $52 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $407 | $407 | $407 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $132 | $132 | $132 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $133 | $133 | $134 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $310 | $338 | $367 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $429 | $429 | $429 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $111 | $111 | $111 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $161 | $161 | $161 |
| EMG needle each extremity complete CPT 95886 • Neurology | $97 | $97 | $97 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $89 | $89 | $90 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $111 | $111 | $112 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $134 | $134 | $134 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $175 | $175 | $175 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $285 | $285 | $285 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $35 | $90 | $165 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $43 | $149 | $255 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $77 | $121 | $163 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $122 | $166 | $216 |
| Office visit established patient minimal CPT 99211 • Office Visits | $22 | $38 | $52 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $36 | $70 | $128 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $35 | $110 | $207 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $45 | $98 | $125 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $75 | $244 | $412 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $32 | $119 | $228 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $81 | $194 | $307 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $138 | $267 | $451 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $49 | $69 | $88 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $59 | $97 | $162 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $91 | $141 | $233 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $10 | $94 | $163 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $109 | $159 | $238 |
| Consultation office straightforward CPT 99241 • Office Visits | $40 | $40 | $40 |
| Consultation office low complexity CPT 99243 • Office Visits | $92 | $114 | $133 |
| Consultation office high complexity CPT 99245 • Office Visits | $146 | $306 | $499 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $601 | $601 | $601 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $37 | $37 | $37 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,130 | $1,130 | $1,130 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,047 | $1,047 | $1,048 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $482 | $482 | $483 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $521 | $521 | $522 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $109 | $109 | $109 |
| Retinal detachment repair with vitrectomy CPT 67108 • Ophthalmology | $1,142 | $1,142 | $1,142 |
| Retinal photocoagulation treatment CPT 67210 • Ophthalmology | $495 | $495 | $495 |
| Retinal treatment extensive photocoagulation CPT 67228 • Ophthalmology | $326 | $326 | $327 |