| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $84 | $130 | $154 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $105 | $122 | $148 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $94 | $134 | $185 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $101 | $124 | $163 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $55 | $55 | $57 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $95 | $100 | $105 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $87 | $117 | $157 |
| Group psychotherapy CPT 90853 • Mental Health | $40 | $43 | $44 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $2 | $2 | $2 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $9 | $9 | $9 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $11 | $11 | $11 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $134 | $134 | $134 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $183 | $267 | $351 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $56 | $56 | $56 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $56 | $56 | $56 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $32 | $32 | $32 |
| EMG needle each extremity complete CPT 95886 • Neurology | $49 | $49 | $49 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $18 | $18 | $18 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $65 | $65 | $65 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $134 | $134 | $134 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $153 | $153 | $153 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $285 | $285 | $285 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $58 | $69 | $91 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $41 | $92 | $129 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $30 | $122 | $178 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $178 | $209 | $236 |
| Office visit established patient minimal CPT 99211 • Office Visits | $19 | $23 | $28 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $54 | $55 | $57 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $13 | $70 | $110 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $122 | $147 | $160 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $71 | $138 | $173 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $67 | $74 | $81 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $13 | $69 | $124 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $30 | $98 | $165 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $3 | $22 | $40 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $7 | $62 | $116 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $97 | $105 | $113 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $10 | $38 | $65 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $93 | $97 | $102 |
| Consultation office low complexity CPT 99243 • Office Visits | $14 | $53 | $92 |
| Consultation office high complexity CPT 99245 • Office Visits | $172 | $192 | $213 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $86 | $86 | $86 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $8 | $8 | $8 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $792 | $792 | $792 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $99 | $99 | $99 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $812 | $812 | $812 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $374 | $374 | $374 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $58 | $58 | $58 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $107 | $107 | $107 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $391 | $391 | $391 |