| Psychotherapy 60 minutes CPT 90837 • Mental Health | $134 | $152 | $169 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $105 | $149 | $171 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $140 | $174 | $207 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $67 | $67 | $67 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $98 | $125 | $150 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $78 | $102 | $127 |
| Group psychotherapy CPT 90853 • Mental Health | $27 | $35 | $44 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $5 | $5 | $5 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $136 | $136 | $136 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $115 | $115 | $115 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $131 | $131 | $131 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $353 | $353 | $353 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $419 | $419 | $419 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $51 | $51 | $51 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $167 | $167 | $167 |
| EMG needle each extremity complete CPT 95886 • Neurology | $94 | $94 | $94 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $53 | $53 | $53 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $52 | $52 | $52 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $79 | $79 | $79 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $106 | $106 | $106 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $185 | $185 | $185 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $55 | $61 | $73 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $84 | $94 | $104 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $30 | $121 | $174 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $50 | $145 | $222 |
| Office visit established patient minimal CPT 99211 • Office Visits | $22 | $24 | $25 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $30 | $43 | $54 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $30 | $51 | $72 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $76 | $106 | $157 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $125 | $133 | $141 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $30 | $64 | $99 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $30 | $82 | $133 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $30 | $85 | $196 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $30 | $34 | $38 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $30 | $50 | $70 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $30 | $65 | $101 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $30 | $50 | $71 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $104 | $121 | $130 |
| Consultation office low complexity CPT 99243 • Office Visits | $94 | $94 | $94 |
| Consultation office high complexity CPT 99245 • Office Visits | $218 | $218 | $218 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $533 | $533 | $533 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $45 | $45 | $45 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,147 | $1,147 | $1,147 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $201 | $201 | $201 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,061 | $1,061 | $1,061 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $488 | $488 | $488 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $291 | $291 | $291 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $727 | $727 | $727 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $530 | $530 | $530 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $98 | $98 | $98 |