| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $89 | $105 | $126 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $112 | $146 | $199 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $117 | $140 | $166 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $178 | $188 | $208 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $67 | $80 | $99 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $87 | $119 | $154 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $121 | $136 | $167 |
| Group psychotherapy CPT 90853 • Mental Health | $40 | $48 | $52 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $0 | $5 | $10 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $11 | $127 | $244 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $44 | $105 | $206 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $49 | $111 | $172 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $80 | $84 | $89 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $235 | $397 | $559 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $59 | $69 | $80 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $34 | $115 | $170 |
| EMG needle each extremity complete CPT 95886 • Neurology | $59 | $64 | $69 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $19 | $51 | $83 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $104 | $111 | $117 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $70 | $89 | $107 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $92 | $198 | $305 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $175 | $180 | $185 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $62 | $156 | $250 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $99 | $229 | $360 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $108 | $269 | $549 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $90 | $323 | $690 |
| Office visit established patient minimal CPT 99211 • Office Visits | $25 | $49 | $72 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $50 | $98 | $146 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $69 | $156 | $243 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $44 | $149 | $359 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $74 | $222 | $371 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $123 | $231 | $339 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $112 | $284 | $457 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $163 | $420 | $677 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $3 | $67 | $131 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $92 | $168 | $243 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $8 | $178 | $348 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $72 | $158 | $244 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $13 | $186 | $360 |
| Consultation office low complexity CPT 99243 • Office Visits | $61 | $234 | $407 |
| Consultation office high complexity CPT 99245 • Office Visits | $143 | $443 | $742 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $57 | $448 | $839 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $36 | $71 | $106 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,429 | $1,626 | $1,822 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $46 | $212 | $378 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $200 | $942 | $1,684 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $93 | $541 | $990 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $29 | $177 | $458 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $44 | $724 | $1,223 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $99 | $542 | $984 |