| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $262 | $262 | $262 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $357 | $357 | $357 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $48 | $48 | $48 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $133 | $133 | $133 |
| EMG needle each extremity complete CPT 95886 • Neurology | $83 | $83 | $83 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $40 | $40 | $40 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $111 | $111 | $111 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $133 | $133 | $133 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $74 | $74 | $74 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $109 | $109 | $109 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $47 | $59 | $72 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $100 | $102 | $103 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $124 | $138 | $153 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $191 | $198 | $205 |
| Office visit established patient minimal CPT 99211 • Office Visits | $9 | $16 | $23 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $40 | $46 | $52 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $67 | $76 | $85 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $99 | $109 | $119 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $134 | $159 | $184 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $71 | $83 | $95 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $96 | $112 | $128 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $161 | $175 | $188 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $37 | $41 | $45 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $58 | $63 | $68 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $93 | $95 | $97 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $67 | $71 | $75 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $99 | $103 | $106 |
| Consultation office straightforward CPT 99241 • Office Visits | $44 | $44 | $44 |
| Consultation office low complexity CPT 99243 • Office Visits | $91 | $91 | $91 |
| Consultation office high complexity CPT 99245 • Office Visits | $179 | $179 | $179 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $524 | $524 | $524 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $51 | $51 | $51 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,084 | $1,084 | $1,084 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $233 | $257 | $281 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,115 | $1,115 | $1,115 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $582 | $582 | $582 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $240 | $240 | $240 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $996 | $996 | $996 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $323 | $521 | $718 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $99 | $101 | $103 |
| Retinal detachment repair with vitrectomy CPT 67108 • Ophthalmology | $1,506 | $1,506 | $1,506 |
| Retinal photocoagulation treatment CPT 67210 • Ophthalmology | $494 | $494 | $494 |
| Retinal treatment extensive photocoagulation CPT 67228 • Ophthalmology | $984 | $984 | $984 |
| Strabismus surgery one horizontal muscle CPT 67311 • Ophthalmology | $564 | $564 | $564 |
| Excision chalazion single CPT 67800 • Ophthalmology | $98 | $98 | $98 |
| Blepharoptosis repair levator resection CPT 67901 • Ophthalmology | $697 | $697 | $697 |
| Lacrimal punctum closure by plug CPT 68761 • Ophthalmology | $63 | $88 | $112 |
| Eye exam new patient intermediate CPT 92002 • Ophthalmology | $24 | $24 | $24 |
| Eye exam new patient comprehensive CPT 92004 • Ophthalmology | $73 | $103 | $133 |
| Eye exam established patient intermediate CPT 92012 • Ophthalmology | $26 | $26 | $26 |