| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $106 | $115 | $124 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $52 | $57 | $62 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $78 | $85 | $91 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $78 | $85 | $91 |
| Group psychotherapy CPT 90853 • Mental Health | $48 | $48 | $49 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $5 | $5 | $5 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $68 | $101 | $135 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $21 | $33 | $45 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $72 | $95 | $117 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $239 | $262 | $285 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $164 | $246 | $328 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $96 | $96 | $97 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $138 | $138 | $138 |
| EMG needle each extremity complete CPT 95886 • Neurology | $14 | $43 | $72 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $77 | $77 | $77 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $54 | $76 | $99 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $118 | $118 | $119 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $70 | $113 | $156 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $151 | $193 | $236 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $6 | $39 | $72 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $81 | $94 | $107 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $45 | $57 | $69 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $45 | $110 | $175 |
| Office visit established patient minimal CPT 99211 • Office Visits | $3 | $11 | $19 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $5 | $22 | $38 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $6 | $36 | $65 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $89 | $89 | $90 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $18 | $79 | $140 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $9 | $77 | $146 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $116 | $131 | $146 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $146 | $166 | $185 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $64 | $64 | $64 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $61 | $63 | $65 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $13 | $54 | $94 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $9 | $38 | $66 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $97 | $97 | $97 |
| Consultation office low complexity CPT 99243 • Office Visits | $45 | $59 | $73 |
| Consultation office high complexity CPT 99245 • Office Visits | $169 | $177 | $185 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $384 | $448 | $512 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $3 | $16 | $30 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $915 | $915 | $916 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $24 | $24 | $24 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $85 | $468 | $850 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $275 | $333 | $392 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $18 | $18 | $18 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $580 | $580 | $580 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $317 | $317 | $317 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $18 | $18 | $18 |
| Retinal detachment repair with vitrectomy CPT 67108 • Ophthalmology | $464 | $464 | $464 |
| Retinal photocoagulation treatment CPT 67210 • Ophthalmology | $77 | $240 | $402 |