| Psychotherapy 60 minutes CPT 90837 • Mental Health | $230 | $230 | $230 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $185 | $185 | $185 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $253 | $253 | $253 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $112 | $112 | $112 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $168 | $168 | $168 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $177 | $177 | $177 |
| Group psychotherapy CPT 90853 • Mental Health | $48 | $48 | $48 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $8 | $8 | $8 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $267 | $267 | $267 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $219 | $219 | $219 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $202 | $202 | $202 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $96 | $96 | $96 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $690 | $690 | $690 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $86 | $86 | $86 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $275 | $275 | $275 |
| EMG needle each extremity complete CPT 95886 • Neurology | $76 | $76 | $76 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $155 | $155 | $155 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $193 | $193 | $193 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $98 | $98 | $98 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $178 | $178 | $178 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $178 | $178 | $178 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $53 | $77 | $125 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $82 | $137 | $193 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $30 | $151 | $289 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $311 | $311 | $311 |
| Office visit established patient minimal CPT 99211 • Office Visits | $15 | $15 | $15 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $43 | $66 | $98 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $65 | $104 | $157 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $106 | $183 | $222 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $312 | $312 | $312 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $97 | $137 | $171 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $171 | $197 | $223 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $296 | $296 | $296 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $85 | $85 | $85 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $97 | $121 | $135 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $203 | $203 | $203 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $139 | $139 | $139 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $196 | $196 | $196 |
| Consultation office low complexity CPT 99243 • Office Visits | $194 | $194 | $194 |
| Consultation office high complexity CPT 99245 • Office Visits | $362 | $362 | $362 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $1,139 | $1,139 | $1,139 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $65 | $65 | $65 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $2,133 | $2,133 | $2,133 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $371 | $371 | $371 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,982 | $1,982 | $1,982 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $920 | $920 | $920 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $544 | $544 | $544 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $1,347 | $1,347 | $1,347 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $983 | $983 | $983 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $165 | $165 | $165 |