| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $111 | $154 | $199 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $159 | $236 | $304 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $147 | $196 | $234 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $141 | $198 | $255 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $46 | $93 | $123 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $137 | $190 | $245 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $107 | $181 | $226 |
| Group psychotherapy CPT 90853 • Mental Health | $24 | $42 | $51 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $6 | $8 | $10 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $97 | $259 | $350 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $247 | $269 | $304 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $202 | $229 | $262 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $73 | $381 | $737 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $73 | $552 | $846 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $105 | $204 | $284 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $144 | $200 | $312 |
| EMG needle each extremity complete CPT 95886 • Neurology | $59 | $112 | $189 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $68 | $128 | $202 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $86 | $182 | $292 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $126 | $179 | $254 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $136 | $271 | $410 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $211 | $429 | $621 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $54 | $117 | $155 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $113 | $159 | $224 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $203 | $291 | $384 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $44 | $288 | $484 |
| Office visit established patient minimal CPT 99211 • Office Visits | $28 | $44 | $57 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $32 | $64 | $90 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $91 | $124 | $152 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $134 | $190 | $251 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $138 | $233 | $302 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $101 | $168 | $213 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $170 | $236 | $288 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $214 | $372 | $480 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $42 | $81 | $130 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $91 | $125 | $152 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $110 | $175 | $220 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $91 | $125 | $153 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $133 | $202 | $254 |
| Consultation office low complexity CPT 99243 • Office Visits | $108 | $193 | $287 |
| Consultation office high complexity CPT 99245 • Office Visits | $278 | $420 | $525 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $1,249 | $1,256 | $1,262 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $143 | $149 | $155 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,474 | $2,057 | $2,641 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $572 | $627 | $682 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,871 | $2,288 | $2,711 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $468 | $788 | $1,424 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $57 | $338 | $665 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $988 | $1,406 | $1,825 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $794 | $1,188 | $1,464 |