| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $81 | $92 | $114 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $121 | $123 | $125 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $99 | $129 | $185 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $110 | $137 | $163 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $53 | $60 | $73 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $108 | $117 | $125 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $92 | $118 | $157 |
| Group psychotherapy CPT 90853 • Mental Health | $40 | $44 | $49 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $1 | $1 | $1 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $9 | $9 | $9 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $69 | $69 | $69 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $21 | $21 | $21 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $183 | $267 | $351 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $56 | $56 | $56 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $56 | $56 | $56 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $32 | $32 | $32 |
| EMG needle each extremity complete CPT 95886 • Neurology | $53 | $53 | $53 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $39 | $39 | $39 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $44 | $44 | $44 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $133 | $133 | $133 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $88 | $88 | $88 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $184 | $184 | $184 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $58 | $80 | $91 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $30 | $96 | $131 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $81 | $159 | $199 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $22 | $145 | $225 |
| Office visit established patient minimal CPT 99211 • Office Visits | $22 | $25 | $28 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $44 | $49 | $54 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $44 | $84 | $110 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $94 | $121 | $160 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $88 | $145 | $175 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $71 | $103 | $135 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $11 | $71 | $130 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $130 | $137 | $143 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $19 | $31 | $42 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $6 | $63 | $116 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $110 | $118 | $126 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $6 | $47 | $89 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $102 | $116 | $131 |
| Consultation office low complexity CPT 99243 • Office Visits | $30 | $64 | $97 |
| Consultation office high complexity CPT 99245 • Office Visits | $191 | $202 | $212 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $120 | $120 | $120 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $18 | $18 | $18 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $989 | $989 | $989 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $173 | $173 | $173 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $786 | $786 | $786 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $338 | $338 | $338 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $30 | $30 | $30 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $107 | $107 | $107 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $428 | $428 | $428 |