| Psychotherapy 30 minutes CPT 90832 • Mental Health | $63 | $74 | $93 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $42 | $69 | $102 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $75 | $98 | $130 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $69 | $88 | $116 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $120 | $146 | $184 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $92 | $114 | $144 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $96 | $132 | $168 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $46 | $81 | $96 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $78 | $115 | $150 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $81 | $120 | $150 |
| Group psychotherapy CPT 90853 • Mental Health | $26 | $44 | $77 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $4 | $5 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $30 | $83 | $136 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $30 | $69 | $109 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $97 | $115 | $134 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $169 | $268 | $367 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $158 | $268 | $379 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $45 | $78 | $111 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $72 | $131 | $161 |
| EMG needle each extremity complete CPT 95886 • Neurology | $48 | $72 | $97 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $52 | $77 | $90 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $48 | $80 | $112 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $134 | $135 | $136 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $75 | $142 | $175 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $110 | $197 | $285 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $55 | $67 | $71 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $81 | $101 | $112 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $96 | $136 | $164 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $157 | $188 | $216 |
| Office visit established patient minimal CPT 99211 • Office Visits | $7 | $22 | $30 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $32 | $50 | $57 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $30 | $58 | $88 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $30 | $91 | $129 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $109 | $132 | $156 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $30 | $86 | $170 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $108 | $136 | $169 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $158 | $180 | $198 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $32 | $69 | $129 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $30 | $71 | $129 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $30 | $82 | $129 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $30 | $73 | $129 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $86 | $112 | $130 |
| Consultation office low complexity CPT 99243 • Office Visits | $30 | $103 | $170 |
| Consultation office high complexity CPT 99245 • Office Visits | $166 | $225 | $255 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $30 | $436 | $758 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $30 | $42 | $53 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $934 | $934 | $934 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $30 | $220 | $368 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $30 | $311 | $872 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $463 | $473 | $483 |