| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $118 | $127 | $132 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $49 | $58 | $70 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $65 | $77 | $88 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $77 | $82 | $92 |
| Group psychotherapy CPT 90853 • Mental Health | $21 | $22 | $25 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $2 | $5 | $10 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $6 | $66 | $126 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $24 | $72 | $120 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $85 | $85 | $85 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $176 | $264 | $352 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $51 | $280 | $410 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $100 | $100 | $101 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $70 | $106 | $141 |
| EMG needle each extremity complete CPT 95886 • Neurology | $43 | $64 | $85 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $80 | $80 | $81 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $41 | $71 | $100 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $50 | $50 | $50 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $95 | $126 | $158 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $259 | $259 | $259 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $4 | $41 | $66 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $13 | $70 | $112 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $19 | $105 | $169 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $117 | $171 | $224 |
| Office visit established patient minimal CPT 99211 • Office Visits | $4 | $13 | $21 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $32 | $45 | $61 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $35 | $52 | $69 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $49 | $92 | $129 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $21 | $93 | $138 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $9 | $45 | $65 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $84 | $101 | $121 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $66 | $108 | $131 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $28 | $37 | $47 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $45 | $60 | $73 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $45 | $79 | $103 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $61 | $65 | $72 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $44 | $78 | $103 |
| Consultation office low complexity CPT 99243 • Office Visits | $8 | $56 | $104 |
| Consultation office high complexity CPT 99245 • Office Visits | $97 | $145 | $193 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $268 | $513 | $758 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $20 | $29 | $39 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $858 | $1,041 | $1,225 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $160 | $264 | $368 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $113 | $113 | $113 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $394 | $394 | $394 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $154 | $225 | $296 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $77 | $532 | $772 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $56 | $282 | $508 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $19 | $95 | $171 |
| Retinal detachment repair with vitrectomy CPT 67108 • Ophthalmology | $615 | $615 | $615 |
| Retinal photocoagulation treatment CPT 67210 • Ophthalmology | $53 | $284 | $515 |