| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $89 | $153 | $218 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $128 | $231 | $335 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $136 | $211 | $286 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $177 | $247 | $317 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $152 | $152 | $152 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $117 | $181 | $244 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $121 | $188 | $254 |
| Group psychotherapy CPT 90853 • Mental Health | $63 | $65 | $67 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $7 | $11 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $333 | $370 | $407 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $101 | $167 | $281 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $117 | $189 | $262 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $254 | $417 | $702 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $140 | $244 | $348 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $126 | $126 | $126 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $128 | $219 | $403 |
| EMG needle each extremity complete CPT 95886 • Neurology | $78 | $97 | $117 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $71 | $83 | $95 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $38 | $83 | $123 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $46 | $97 | $147 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $138 | $200 | $261 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $224 | $471 | $717 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $108 | $137 | $165 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $227 | $241 | $255 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $136 | $211 | $348 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $189 | $378 | $505 |
| Office visit established patient minimal CPT 99211 • Office Visits | $20 | $36 | $52 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $95 | $112 | $128 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $110 | $158 | $207 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $99 | $149 | $230 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $310 | $361 | $412 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $218 | $223 | $228 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $295 | $301 | $307 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $185 | $356 | $451 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $84 | $86 | $88 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $155 | $159 | $162 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $224 | $228 | $233 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $156 | $160 | $163 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $98 | $189 | $238 |
| Consultation office low complexity CPT 99243 • Office Visits | $142 | $164 | $208 |
| Consultation office high complexity CPT 99245 • Office Visits | $206 | $373 | $499 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $479 | $976 | $1,474 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $39 | $75 | $111 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,174 | $2,011 | $2,848 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $248 | $420 | $593 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $2,627 | $2,627 | $2,627 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $1,204 | $1,204 | $1,204 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $304 | $510 | $716 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $744 | $1,274 | $1,803 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $543 | $929 | $1,314 |