| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $87 | $164 | $240 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $185 | $294 | $403 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $123 | $220 | $318 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $150 | $268 | $387 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $72 | $132 | $191 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $134 | $199 | $263 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $113 | $194 | $275 |
| Group psychotherapy CPT 90853 • Mental Health | $69 | $71 | $73 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $0 | $6 | $12 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $93 | $281 | $583 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $23 | $257 | $433 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $94 | $281 | $461 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $73 | $113 | $152 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $152 | $291 | $430 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $61 | $99 | $136 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $81 | $147 | $213 |
| EMG needle each extremity complete CPT 95886 • Neurology | $49 | $86 | $122 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $38 | $90 | $142 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $65 | $183 | $300 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $78 | $145 | $213 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $105 | $194 | $282 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $101 | $301 | $501 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $11 | $111 | $182 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $109 | $197 | $263 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $20 | $249 | $403 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $27 | $266 | $418 |
| Office visit established patient minimal CPT 99211 • Office Visits | $2 | $32 | $48 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $5 | $73 | $110 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $9 | $105 | $178 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $19 | $112 | $192 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $150 | $262 | $354 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $49 | $154 | $250 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $114 | $236 | $339 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $193 | $345 | $501 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $97 | $104 | $116 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $98 | $144 | $179 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $87 | $193 | $257 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $87 | $141 | $179 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $111 | $200 | $265 |
| Consultation office low complexity CPT 99243 • Office Visits | $117 | $197 | $301 |
| Consultation office high complexity CPT 99245 • Office Visits | $18 | $309 | $551 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $90 | $1,265 | $2,228 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $28 | $126 | $252 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,131 | $2,884 | $4,381 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $178 | $611 | $999 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $786 | $2,420 | $3,566 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $48 | $1,251 | $2,363 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $58 | $575 | $870 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $143 | $1,688 | $2,937 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $52 | $1,286 | $2,359 |