| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $141 | $147 | $153 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $46 | $49 | $52 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $72 | $84 | $96 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $87 | $93 | $100 |
| Group psychotherapy CPT 90853 • Mental Health | $22 | $31 | $40 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $4 | $4 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $12 | $66 | $121 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $13 | $13 | $13 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $25 | $72 | $120 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $178 | $267 | $355 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $362 | $387 | $412 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $55 | $80 | $105 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $75 | $110 | $144 |
| EMG needle each extremity complete CPT 95886 • Neurology | $44 | $67 | $91 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $83 | $83 | $84 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $21 | $63 | $105 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $25 | $25 | $25 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $99 | $132 | $165 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $92 | $181 | $270 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $63 | $73 | $82 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $37 | $88 | $140 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $109 | $117 | $126 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $191 | $228 | $265 |
| Office visit established patient minimal CPT 99211 • Office Visits | $20 | $33 | $45 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $7 | $28 | $49 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $25 | $61 | $98 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $17 | $79 | $141 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $13 | $101 | $189 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $72 | $86 | $100 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $114 | $122 | $130 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $15 | $84 | $153 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $43 | $43 | $43 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $70 | $75 | $80 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $15 | $60 | $105 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $7 | $39 | $71 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $10 | $56 | $101 |
| Consultation office low complexity CPT 99243 • Office Visits | $80 | $80 | $81 |
| Consultation office high complexity CPT 99245 • Office Visits | $17 | $109 | $200 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $410 | $495 | $580 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $4 | $20 | $36 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $826 | $826 | $826 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $46 | $46 | $46 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $153 | $583 | $1,013 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $47 | $258 | $468 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $110 | $110 | $110 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $104 | $397 | $690 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $380 | $380 | $380 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $9 | $57 | $105 |
| Retinal detachment repair with vitrectomy CPT 67108 • Ophthalmology | $221 | $221 | $221 |
| Retinal photocoagulation treatment CPT 67210 • Ophthalmology | $96 | $287 | $478 |