| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $53 | $64 | $76 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $90 | $103 | $116 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $78 | $98 | $119 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $103 | $123 | $143 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $40 | $54 | $68 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $73 | $91 | $110 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $67 | $90 | $114 |
| Group psychotherapy CPT 90853 • Mental Health | $20 | $33 | $46 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $3 | $3 | $3 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $48 | $73 | $99 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $83 | $119 | $155 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $83 | $119 | $156 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $183 | $293 | $403 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $252 | $326 | $401 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $83 | $120 | $138 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $59 | $151 | $197 |
| EMG needle each extremity complete CPT 95886 • Neurology | $33 | $68 | $103 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $26 | $68 | $110 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $36 | $107 | $143 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $41 | $59 | $77 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $122 | $173 | $224 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $77 | $210 | $344 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $32 | $60 | $87 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $48 | $51 | $55 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $93 | $137 | $198 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $147 | $183 | $246 |
| Office visit established patient minimal CPT 99211 • Office Visits | $12 | $30 | $48 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $27 | $37 | $48 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $32 | $40 | $48 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $50 | $101 | $127 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $48 | $64 | $80 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $48 | $56 | $65 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $48 | $74 | $99 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $48 | $140 | $245 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $25 | $36 | $48 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $46 | $47 | $48 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $48 | $57 | $66 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $46 | $47 | $48 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $76 | $113 | $132 |
| Consultation office low complexity CPT 99243 • Office Visits | $15 | $71 | $127 |
| Consultation office high complexity CPT 99245 • Office Visits | $48 | $160 | $271 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $48 | $240 | $433 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $33 | $41 | $48 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $836 | $836 | $836 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $130 | $152 | $173 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $48 | $409 | $770 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $353 | $400 | $424 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $183 | $190 | $198 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $497 | $497 | $497 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $385 | $385 | $385 |