| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $94 | $147 | $199 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $143 | $239 | $335 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $146 | $216 | $286 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $176 | $263 | $349 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $71 | $119 | $167 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $115 | $145 | $175 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $141 | $161 | $181 |
| Group psychotherapy CPT 90853 • Mental Health | $40 | $45 | $49 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $11 | $11 | $11 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $153 | $280 | $407 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $207 | $244 | $281 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $297 | $297 | $297 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $618 | $618 | $618 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $857 | $857 | $857 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $114 | $120 | $126 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $165 | $177 | $200 |
| EMG needle each extremity complete CPT 95886 • Neurology | $228 | $228 | $228 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $130 | $130 | $130 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $146 | $177 | $208 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $147 | $147 | $147 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $450 | $450 | $450 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $260 | $260 | $260 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $160 | $163 | $165 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $191 | $223 | $255 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $207 | $246 | $284 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $168 | $290 | $441 |
| Office visit established patient minimal CPT 99211 • Office Visits | $40 | $46 | $52 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $97 | $113 | $128 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $158 | $182 | $207 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $8 | $88 | $218 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $242 | $327 | $412 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $218 | $223 | $228 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $295 | $301 | $307 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $254 | $333 | $451 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $84 | $86 | $88 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $134 | $148 | $162 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $224 | $228 | $233 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $137 | $150 | $163 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $135 | $201 | $238 |
| Consultation office low complexity CPT 99243 • Office Visits | $150 | $152 | $155 |
| Consultation office high complexity CPT 99245 • Office Visits | $281 | $362 | $499 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $1,474 | $1,474 | $1,474 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $111 | $111 | $111 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,291 | $2,056 | $2,820 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $386 | $489 | $593 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $2,624 | $2,624 | $2,624 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $698 | $951 | $1,204 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $567 | $567 | $567 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $1,784 | $1,784 | $1,784 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $1,303 | $1,303 | $1,303 |