| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $75 | $93 | $116 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $99 | $128 | $157 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $92 | $119 | $145 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $101 | $138 | $177 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $46 | $66 | $81 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $78 | $104 | $128 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $77 | $118 | $150 |
| Group psychotherapy CPT 90853 • Mental Health | $30 | $47 | $58 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $1 | $3 | $5 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $30 | $30 | $30 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $114 | $114 | $114 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $67 | $67 | $67 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $311 | $311 | $311 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $379 | $404 | $430 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $56 | $56 | $56 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $161 | $161 | $161 |
| EMG needle each extremity complete CPT 95886 • Neurology | $97 | $97 | $98 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $89 | $89 | $90 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $112 | $112 | $112 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $78 | $106 | $134 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $88 | $131 | $175 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $184 | $184 | $184 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $53 | $66 | $72 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $82 | $102 | $112 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $159 | $164 | $169 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $178 | $188 | $205 |
| Office visit established patient minimal CPT 99211 • Office Visits | $6 | $17 | $30 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $46 | $50 | $57 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $33 | $66 | $88 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $77 | $107 | $125 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $26 | $128 | $184 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $49 | $86 | $170 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $20 | $91 | $131 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $124 | $168 | $198 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $30 | $62 | $129 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $64 | $93 | $129 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $50 | $91 | $129 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $72 | $97 | $129 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $97 | $110 | $129 |
| Consultation office low complexity CPT 99243 • Office Visits | $92 | $136 | $171 |
| Consultation office high complexity CPT 99245 • Office Visits | $30 | $152 | $254 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $30 | $363 | $758 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $19 | $24 | $30 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,131 | $1,131 | $1,131 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $178 | $273 | $368 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $30 | $277 | $524 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $338 | $338 | $338 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $34 | $165 | $296 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $663 | $689 | $715 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $355 | $438 | $522 |