| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $76 | $107 | $169 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $103 | $159 | $258 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $101 | $155 | $243 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $107 | $182 | $297 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $68 | $93 | $142 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $93 | $137 | $208 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $86 | $139 | $217 |
| Group psychotherapy CPT 90853 • Mental Health | $45 | $55 | $63 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $1 | $5 | $10 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $19 | $185 | $407 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $40 | $156 | $272 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $55 | $129 | $222 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $50 | $157 | $303 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $302 | $501 | $847 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $21 | $85 | $132 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $30 | $117 | $173 |
| EMG needle each extremity complete CPT 95886 • Neurology | $77 | $85 | $99 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $83 | $92 | $111 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $105 | $106 | $108 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $70 | $118 | $166 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $75 | $209 | $383 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $95 | $321 | $609 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $41 | $114 | $165 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $44 | $146 | $255 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $133 | $185 | $236 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $139 | $205 | $308 |
| Office visit established patient minimal CPT 99211 • Office Visits | $4 | $24 | $52 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $40 | $83 | $128 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $57 | $119 | $207 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $40 | $99 | $144 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $91 | $255 | $412 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $42 | $152 | $228 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $40 | $199 | $307 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $166 | $329 | $451 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $5 | $55 | $88 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $30 | $108 | $162 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $13 | $145 | $233 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $40 | $112 | $163 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $85 | $173 | $238 |
| Consultation office low complexity CPT 99243 • Office Visits | $71 | $112 | $177 |
| Consultation office high complexity CPT 99245 • Office Visits | $40 | $297 | $499 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $345 | $697 | $1,253 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $15 | $46 | $94 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $613 | $1,517 | $2,421 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $15 | $208 | $425 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $81 | $1,042 | $2,233 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $56 | $485 | $1,023 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $131 | $305 | $609 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $40 | $663 | $1,533 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $81 | $599 | $1,117 |