| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $98 | $119 | $154 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $130 | $145 | $154 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $113 | $133 | $149 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $142 | $158 | $181 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $50 | $62 | $81 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $104 | $116 | $131 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $108 | $130 | $145 |
| Group psychotherapy CPT 90853 • Mental Health | $41 | $55 | $66 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $6 | $6 | $6 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $30 | $61 | $93 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $20 | $75 | $131 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $67 | $67 | $67 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $351 | $351 | $351 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $430 | $430 | $430 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $111 | $111 | $111 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $80 | $121 | $161 |
| EMG needle each extremity complete CPT 95886 • Neurology | $49 | $73 | $97 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $38 | $63 | $89 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $112 | $112 | $112 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $56 | $56 | $56 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $88 | $131 | $175 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $143 | $143 | $143 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $59 | $80 | $91 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $8 | $84 | $138 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $129 | $161 | $196 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $178 | $206 | $225 |
| Office visit established patient minimal CPT 99211 • Office Visits | $1 | $18 | $30 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $8 | $36 | $54 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $86 | $89 | $95 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $30 | $105 | $160 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $164 | $181 | $192 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $74 | $138 | $171 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $131 | $139 | $155 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $29 | $127 | $198 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $47 | $91 | $129 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $69 | $97 | $129 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $15 | $88 | $129 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $30 | $79 | $129 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $129 | $132 | $136 |
| Consultation office low complexity CPT 99243 • Office Visits | $18 | $67 | $92 |
| Consultation office high complexity CPT 99245 • Office Visits | $172 | $227 | $255 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $30 | $215 | $399 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $6 | $18 | $30 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $848 | $989 | $1,130 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $20 | $108 | $197 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $30 | $382 | $733 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $362 | $362 | $362 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $30 | $128 | $227 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $536 | $536 | $536 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $391 | $391 | $391 |