| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $50 | $76 | $116 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $87 | $93 | $99 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $81 | $107 | $133 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $115 | $123 | $130 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $48 | $54 | $60 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $62 | $98 | $116 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $77 | $103 | $116 |
| Group psychotherapy CPT 90853 • Mental Health | $18 | $20 | $22 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $4 | $4 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $124 | $132 | $140 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $104 | $124 | $143 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $105 | $124 | $143 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $128 | $259 | $390 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $140 | $297 | $453 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $25 | $82 | $111 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $55 | $124 | $159 |
| EMG needle each extremity complete CPT 95886 • Neurology | $70 | $83 | $96 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $75 | $81 | $87 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $43 | $87 | $109 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $52 | $55 | $58 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $67 | $119 | $171 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $99 | $188 | $278 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $47 | $58 | $70 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $30 | $49 | $67 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $30 | $90 | $137 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $105 | $158 | $212 |
| Office visit established patient minimal CPT 99211 • Office Visits | $6 | $15 | $23 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $16 | $36 | $55 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $45 | $46 | $47 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $67 | $88 | $108 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $30 | $60 | $90 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $63 | $71 | $78 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $86 | $104 | $122 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $127 | $151 | $164 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $26 | $36 | $46 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $47 | $61 | $74 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $67 | $90 | $112 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $47 | $62 | $76 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $68 | $95 | $109 |
| Consultation office low complexity CPT 99243 • Office Visits | $69 | $99 | $129 |
| Consultation office high complexity CPT 99245 • Office Visits | $163 | $213 | $238 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $496 | $528 | $560 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $48 | $49 | $50 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $825 | $825 | $825 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $240 | $240 | $240 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $826 | $1,106 | $1,386 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $441 | $579 | $648 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $286 | $286 | $286 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $743 | $743 | $743 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $534 | $534 | $534 |