| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $120 | $180 | $240 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $201 | $256 | $310 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $138 | $228 | $318 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $165 | $276 | $387 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $82 | $119 | $156 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $78 | $106 | $134 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $130 | $145 | $159 |
| Group psychotherapy CPT 90853 • Mental Health | $30 | $52 | $73 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $9 | $9 | $9 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $139 | $154 | $168 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $147 | $220 | $298 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $108 | $236 | $363 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $64 | $179 | $320 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $357 | $504 | $652 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $97 | $120 | $164 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $28 | $200 | $431 |
| EMG needle each extremity complete CPT 95886 • Neurology | $95 | $178 | $261 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $99 | $101 | $102 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $63 | $104 | $126 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $360 | $360 | $360 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $199 | $256 | $314 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $314 | $320 | $326 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $80 | $87 | $94 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $113 | $138 | $162 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $109 | $216 | $325 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $168 | $343 | $433 |
| Office visit established patient minimal CPT 99211 • Office Visits | $24 | $34 | $45 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $43 | $45 | $48 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $79 | $82 | $85 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $154 | $218 | $250 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $153 | $168 | $183 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $159 | $163 | $168 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $159 | $193 | $227 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $210 | $254 | $341 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $75 | $86 | $97 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $75 | $97 | $119 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $108 | $139 | $171 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $76 | $97 | $119 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $112 | $133 | $176 |
| Consultation office low complexity CPT 99243 • Office Visits | $114 | $168 | $223 |
| Consultation office high complexity CPT 99245 • Office Visits | $21 | $224 | $416 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $523 | $787 | $1,052 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $8 | $60 | $117 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $941 | $1,437 | $1,933 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $377 | $516 | $655 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $967 | $1,488 | $2,009 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $510 | $687 | $1,041 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $433 | $615 | $797 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $1,365 | $1,674 | $1,983 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $997 | $1,147 | $1,296 |