| Interactive complexity add-on CPT 90785 • Mental Health | $6 | $10 | $15 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $154 | $172 | $191 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $133 | $177 | $212 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $52 | $81 | $98 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $67 | $92 | $106 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $67 | $97 | $130 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $69 | $90 | $116 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $133 | $135 | $138 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $92 | $138 | $198 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $96 | $154 | $212 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $57 | $71 | $96 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $78 | $107 | $150 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $76 | $133 | $174 |
| Group psychotherapy CPT 90853 • Mental Health | $30 | $39 | $49 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $5 | $5 | $6 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $183 | $183 | $183 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $30 | $30 | $30 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $134 | $157 | $181 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $367 | $434 | $501 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $379 | $490 | $602 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $94 | $125 | $156 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $134 | $147 | $161 |
| EMG needle each extremity complete CPT 95886 • Neurology | $133 | $133 | $133 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $52 | $88 | $123 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $97 | $127 | $156 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $78 | $106 | $134 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $175 | $210 | $245 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $285 | $340 | $395 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $71 | $84 | $110 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $65 | $89 | $112 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $139 | $163 | $186 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $177 | $190 | $205 |
| Office visit established patient minimal CPT 99211 • Office Visits | $21 | $35 | $53 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $21 | $44 | $56 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $30 | $80 | $118 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $30 | $93 | $160 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $121 | $171 | $220 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $30 | $99 | $201 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $103 | $152 | $201 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $137 | $209 | $292 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $39 | $81 | $124 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $30 | $74 | $124 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $30 | $94 | $150 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $30 | $77 | $128 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $130 | $143 | $155 |
| Consultation office low complexity CPT 99243 • Office Visits | $30 | $30 | $30 |
| Consultation office high complexity CPT 99245 • Office Visits | $237 | $246 | $255 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $758 | $822 | $885 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $60 | $60 | $60 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $3,243 | $3,243 | $3,243 |