| Psychotherapy 45 minutes CPT 90834 • Mental Health | $69 | $106 | $172 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $68 | $107 | $185 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $99 | $153 | $258 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $91 | $141 | $223 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $122 | $174 | $269 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $44 | $78 | $142 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $67 | $116 | $209 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $76 | $128 | $216 |
| Group psychotherapy CPT 90853 • Mental Health | $18 | $43 | $57 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $1 | $5 | $10 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $17 | $236 | $407 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $19 | $117 | $239 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $17 | $131 | $270 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $347 | $432 | $597 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $81 | $446 | $847 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $54 | $97 | $132 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $71 | $129 | $173 |
| EMG needle each extremity complete CPT 95886 • Neurology | $43 | $78 | $99 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $41 | $79 | $111 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $21 | $77 | $106 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $62 | $105 | $128 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $81 | $210 | $383 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $133 | $339 | $609 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $31 | $96 | $165 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $48 | $147 | $255 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $14 | $136 | $296 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $163 | $269 | $375 |
| Office visit established patient minimal CPT 99211 • Office Visits | $6 | $33 | $52 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $48 | $86 | $128 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $49 | $130 | $207 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $8 | $74 | $196 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $19 | $211 | $412 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $11 | $141 | $228 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $113 | $224 | $307 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $151 | $324 | $451 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $36 | $65 | $88 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $10 | $101 | $162 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $10 | $144 | $233 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $11 | $102 | $163 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $10 | $148 | $238 |
| Consultation office low complexity CPT 99243 • Office Visits | $43 | $124 | $224 |
| Consultation office high complexity CPT 99245 • Office Visits | $148 | $352 | $499 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $383 | $670 | $1,120 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $28 | $54 | $94 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $909 | $1,512 | $2,421 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $148 | $326 | $504 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $111 | $1,152 | $2,233 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $359 | $631 | $1,023 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $168 | $325 | $482 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $762 | $1,147 | $1,533 |