| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $95 | $116 | $137 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $120 | $132 | $144 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $124 | $141 | $158 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $150 | $159 | $167 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $68 | $70 | $72 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $105 | $118 | $132 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $108 | $120 | $132 |
| Group psychotherapy CPT 90853 • Mental Health | $29 | $39 | $49 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $5 | $6 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $152 | $168 | $184 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $42 | $163 | $292 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $152 | $217 | $282 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $323 | $334 | $344 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $62 | $216 | $370 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $76 | $97 | $107 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $100 | $134 | $151 |
| EMG needle each extremity complete CPT 95886 • Neurology | $49 | $64 | $79 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $47 | $65 | $83 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $71 | $93 | $104 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $68 | $77 | $86 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $115 | $141 | $168 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $128 | $193 | $259 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $63 | $78 | $92 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $76 | $103 | $130 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $42 | $64 | $108 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $42 | $75 | $142 |
| Office visit established patient minimal CPT 99211 • Office Visits | $7 | $17 | $28 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $38 | $47 | $55 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $57 | $73 | $90 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $42 | $50 | $67 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $93 | $133 | $174 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $84 | $116 | $148 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $113 | $138 | $164 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $42 | $149 | $239 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $32 | $74 | $115 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $59 | $87 | $115 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $84 | $104 | $123 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $60 | $87 | $115 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $87 | $113 | $127 |
| Consultation office low complexity CPT 99243 • Office Visits | $42 | $100 | $149 |
| Consultation office high complexity CPT 99245 • Office Visits | $185 | $241 | $270 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $512 | $710 | $907 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $28 | $55 | $81 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $914 | $914 | $914 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $161 | $161 | $161 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $849 | $1,002 | $1,155 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $392 | $640 | $763 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $42 | $139 | $235 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $42 | $311 | $581 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $42 | $233 | $423 |