| Psychotherapy 60 minutes CPT 90837 • Mental Health | $119 | $145 | $184 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $88 | $106 | $142 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $134 | $144 | $154 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $50 | $68 | $95 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $78 | $113 | $150 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $76 | $110 | $150 |
| Group psychotherapy CPT 90853 • Mental Health | $30 | $36 | $40 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $3 | $4 | $4 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $190 | $190 | $190 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $30 | $30 | $30 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $134 | $171 | $209 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $367 | $403 | $440 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $379 | $447 | $516 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $111 | $123 | $134 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $161 | $161 | $161 |
| EMG needle each extremity complete CPT 95886 • Neurology | $118 | $118 | $118 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $107 | $108 | $109 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $112 | $124 | $136 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $134 | $134 | $134 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $175 | $195 | $214 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $285 | $317 | $348 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $59 | $69 | $73 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $105 | $108 | $112 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $96 | $135 | $164 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $142 | $193 | $216 |
| Office visit established patient minimal CPT 99211 • Office Visits | $21 | $34 | $61 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $7 | $40 | $61 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $30 | $63 | $86 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $30 | $92 | $125 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $142 | $152 | $171 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $30 | $73 | $128 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $121 | $127 | $137 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $120 | $153 | $202 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $40 | $56 | $82 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $30 | $60 | $82 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $30 | $88 | $113 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $30 | $63 | $82 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $93 | $118 | $143 |
| Consultation office low complexity CPT 99243 • Office Visits | $30 | $78 | $108 |
| Consultation office high complexity CPT 99245 • Office Visits | $172 | $217 | $255 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $576 | $667 | $758 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $75 | $75 | $75 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,130 | $1,130 | $1,130 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $368 | $368 | $368 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $30 | $1,054 | $2,077 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $483 | $718 | $953 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $296 | $432 | $568 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $747 | $747 | $747 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $30 | $193 | $355 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $30 | $75 | $119 |