| Psychotherapy 60 minutes CPT 90837 • Mental Health | $99 | $119 | $139 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $154 | $154 | $154 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $145 | $145 | $145 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $82 | $82 | $82 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $112 | $112 | $112 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $137 | $137 | $137 |
| Group psychotherapy CPT 90853 • Mental Health | $36 | $36 | $36 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $5 | $6 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $86 | $86 | $86 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $168 | $168 | $168 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $173 | $173 | $173 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $374 | $374 | $374 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $75 | $75 | $75 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $67 | $67 | $67 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $208 | $208 | $208 |
| EMG needle each extremity complete CPT 95886 • Neurology | $47 | $47 | $47 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $45 | $45 | $45 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $59 | $59 | $59 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $73 | $73 | $73 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $91 | $91 | $91 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $315 | $315 | $315 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $66 | $80 | $94 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $103 | $119 | $134 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $167 | $168 | $169 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $219 | $222 | $225 |
| Office visit established patient minimal CPT 99211 • Office Visits | $21 | $21 | $21 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $46 | $49 | $52 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $91 | $92 | $93 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $82 | $83 | $85 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $120 | $144 | $168 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $76 | $93 | $110 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $113 | $145 | $178 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $128 | $194 | $261 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $42 | $52 | $61 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $73 | $76 | $78 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $103 | $108 | $113 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $75 | $77 | $79 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $106 | $111 | $116 |
| Consultation office low complexity CPT 99243 • Office Visits | $126 | $126 | $126 |
| Consultation office high complexity CPT 99245 • Office Visits | $208 | $208 | $208 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $646 | $646 | $646 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $57 | $57 | $57 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,271 | $1,271 | $1,271 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $233 | $297 | $360 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,356 | $1,356 | $1,356 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $618 | $618 | $618 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $366 | $366 | $366 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $935 | $935 | $935 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $461 | $571 | $680 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $103 | $106 | $109 |