| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $84 | $89 | $98 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $105 | $140 | $157 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $94 | $136 | $191 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $101 | $136 | $177 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $57 | $74 | $95 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $99 | $113 | $127 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $113 | $130 | $162 |
| Group psychotherapy CPT 90853 • Mental Health | $16 | $41 | $66 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $4 | $5 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $30 | $30 | $30 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $66 | $66 | $66 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $79 | $79 | $79 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $56 | $56 | $56 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $56 | $56 | $56 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $22 | $22 | $22 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $32 | $97 | $161 |
| EMG needle each extremity complete CPT 95886 • Neurology | $53 | $75 | $97 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $38 | $63 | $89 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $112 | $112 | $112 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $27 | $41 | $55 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $175 | $175 | $175 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $101 | $101 | $101 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $53 | $71 | $92 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $79 | $106 | $133 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $132 | $134 | $135 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $162 | $170 | $178 |
| Office visit established patient minimal CPT 99211 • Office Visits | $16 | $22 | $28 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $43 | $51 | $57 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $33 | $65 | $88 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $16 | $88 | $125 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $21 | $100 | $145 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $67 | $112 | $170 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $30 | $85 | $131 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $24 | $129 | $198 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $40 | $93 | $129 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $33 | $79 | $129 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $96 | $112 | $129 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $65 | $97 | $129 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $102 | $113 | $129 |
| Consultation office low complexity CPT 99243 • Office Visits | $92 | $110 | $145 |
| Consultation office high complexity CPT 99245 • Office Visits | $172 | $214 | $254 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $30 | $316 | $601 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $4 | $17 | $30 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $792 | $792 | $792 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $30 | $89 | $148 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $30 | $539 | $1,048 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $362 | $362 | $362 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $227 | $227 | $227 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $358 | $358 | $358 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $78 | $300 | $521 |