| Psychotherapy 60 minutes CPT 90837 • Mental Health | $120 | $120 | $120 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $110 | $110 | $110 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $118 | $118 | $118 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $59 | $59 | $59 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $76 | $76 | $76 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $94 | $94 | $94 |
| Group psychotherapy CPT 90853 • Mental Health | $27 | $27 | $27 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $5 | $5 | $5 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $132 | $132 | $132 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $108 | $108 | $108 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $123 | $123 | $123 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $185 | $185 | $185 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $187 | $187 | $187 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $74 | $74 | $74 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $69 | $69 | $69 |
| EMG needle each extremity complete CPT 95886 • Neurology | $47 | $47 | $47 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $41 | $41 | $41 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $49 | $49 | $49 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $137 | $137 | $137 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $180 | $180 | $180 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $114 | $114 | $114 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $55 | $55 | $55 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $81 | $81 | $81 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $99 | $99 | $99 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $128 | $128 | $128 |
| Office visit established patient minimal CPT 99211 • Office Visits | $17 | $17 | $17 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $33 | $33 | $33 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $53 | $53 | $53 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $79 | $79 | $79 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $108 | $108 | $108 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $77 | $77 | $77 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $105 | $105 | $105 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $155 | $155 | $155 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $32 | $32 | $32 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $57 | $57 | $57 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $81 | $81 | $81 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $58 | $58 | $58 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $83 | $83 | $83 |
| Consultation office low complexity CPT 99243 • Office Visits | $84 | $84 | $84 |
| Consultation office high complexity CPT 99245 • Office Visits | $197 | $197 | $197 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $515 | $515 | $515 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $52 | $52 | $52 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $932 | $932 | $932 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $253 | $253 | $253 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $852 | $852 | $852 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $453 | $453 | $453 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $328 | $328 | $328 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $782 | $782 | $782 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $555 | $555 | $555 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $126 | $126 | $126 |