| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $96 | $133 | $167 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $57 | $62 | $69 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $78 | $111 | $132 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $76 | $106 | $132 |
| Group psychotherapy CPT 90853 • Mental Health | $28 | $43 | $66 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $4 | $5 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $9 | $85 | $184 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $31 | $68 | $130 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $115 | $132 | $152 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $57 | $208 | $387 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $50 | $288 | $379 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $63 | $95 | $116 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $79 | $105 | $151 |
| EMG needle each extremity complete CPT 95886 • Neurology | $16 | $57 | $86 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $17 | $46 | $83 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $51 | $93 | $112 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $25 | $53 | $73 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $34 | $129 | $186 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $52 | $190 | $262 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $4 | $56 | $92 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $30 | $86 | $151 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $30 | $97 | $160 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $30 | $104 | $203 |
| Office visit established patient minimal CPT 99211 • Office Visits | $9 | $19 | $30 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $23 | $33 | $52 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $30 | $46 | $73 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $30 | $66 | $119 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $30 | $107 | $156 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $8 | $80 | $148 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $51 | $137 | $198 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $76 | $195 | $264 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $15 | $54 | $115 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $71 | $92 | $115 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $8 | $84 | $123 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $54 | $86 | $115 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $95 | $119 | $148 |
| Consultation office low complexity CPT 99243 • Office Visits | $42 | $68 | $121 |
| Consultation office high complexity CPT 99245 • Office Visits | $70 | $187 | $269 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $230 | $525 | $758 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $30 | $35 | $45 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $983 | $1,070 | $1,157 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $43 | $204 | $286 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $42 | $755 | $1,155 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $114 | $456 | $763 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $53 | $213 | $296 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $42 | $395 | $733 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $355 | $423 | $534 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $12 | $88 | $120 |
| Retinal detachment repair with vitrectomy CPT 67108 • Ophthalmology | $1,082 | $1,127 | $1,172 |
| Retinal photocoagulation treatment CPT 67210 • Ophthalmology | $308 | $481 | $615 |