| Psychotherapy 60 minutes CPT 90837 • Mental Health | $141 | $242 | $342 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $315 | $315 | $315 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $478 | $478 | $478 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $248 | $248 | $248 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $249 | $249 | $249 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $120 | $211 | $303 |
| Group psychotherapy CPT 90853 • Mental Health | $84 | $84 | $84 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $5 | $9 | $14 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $124 | $266 | $407 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $450 | $450 | $450 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $324 | $324 | $324 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $367 | $392 | $413 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $407 | $436 | $465 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $98 | $98 | $98 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $223 | $223 | $223 |
| EMG needle each extremity complete CPT 95886 • Neurology | $246 | $246 | $246 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $149 | $149 | $149 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $142 | $142 | $142 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $223 | $223 | $223 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $298 | $298 | $298 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $853 | $853 | $853 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $38 | $102 | $167 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $74 | $161 | $247 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $30 | $185 | $351 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $30 | $188 | $367 |
| Office visit established patient minimal CPT 99211 • Office Visits | $8 | $31 | $54 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $32 | $47 | $62 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $93 | $95 | $98 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $77 | $143 | $213 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $130 | $220 | $309 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $78 | $126 | $175 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $146 | $219 | $291 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $162 | $250 | $407 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $56 | $72 | $87 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $66 | $105 | $144 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $110 | $158 | $205 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $58 | $121 | $183 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $85 | $144 | $250 |
| Consultation office low complexity CPT 99243 • Office Visits | $240 | $240 | $240 |
| Consultation office high complexity CPT 99245 • Office Visits | $237 | $316 | $473 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $1,465 | $1,465 | $1,465 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $157 | $157 | $157 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $2,671 | $2,671 | $2,671 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $888 | $888 | $888 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $2,428 | $2,428 | $2,428 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $1,291 | $1,291 | $1,291 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $942 | $942 | $942 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $2,332 | $2,332 | $2,332 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $1,776 | $1,776 | $1,776 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $368 | $368 | $368 |