| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $78 | $118 | $185 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $79 | $151 | $284 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $90 | $138 | $220 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $124 | $181 | $296 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $52 | $82 | $142 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $78 | $125 | $205 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $69 | $124 | $214 |
| Group psychotherapy CPT 90853 • Mental Health | $48 | $51 | $56 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $6 | $11 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $40 | $131 | $223 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $28 | $258 | $488 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $77 | $237 | $397 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $149 | $407 | $665 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $45 | $429 | $813 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $68 | $89 | $109 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $65 | $112 | $172 |
| EMG needle each extremity complete CPT 95886 • Neurology | $74 | $92 | $111 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $80 | $85 | $90 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $49 | $153 | $257 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $66 | $117 | $168 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $67 | $123 | $180 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $157 | $202 | $247 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $91 | $113 | $134 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $41 | $86 | $132 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $104 | $162 | $225 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $173 | $280 | $364 |
| Office visit established patient minimal CPT 99211 • Office Visits | $25 | $33 | $41 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $21 | $51 | $81 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $59 | $96 | $132 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $104 | $142 | $191 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $119 | $191 | $256 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $146 | $162 | $177 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $40 | $140 | $239 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $40 | $196 | $351 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $5 | $37 | $68 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $87 | $106 | $125 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $90 | $135 | $181 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $9 | $68 | $127 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $41 | $114 | $186 |
| Consultation office low complexity CPT 99243 • Office Visits | $114 | $195 | $252 |
| Consultation office high complexity CPT 99245 • Office Visits | $206 | $300 | $394 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $253 | $1,238 | $2,224 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $30 | $80 | $131 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $657 | $1,920 | $4,226 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $77 | $483 | $889 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $81 | $2,004 | $3,926 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $262 | $1,038 | $1,814 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $156 | $502 | $848 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $388 | $1,536 | $2,683 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $81 | $1,019 | $1,957 |