| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $122 | $132 | $143 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $51 | $60 | $68 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $82 | $96 | $110 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $86 | $100 | $114 |
| Group psychotherapy CPT 90853 • Mental Health | $45 | $46 | $46 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $1 | $1 | $1 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $13 | $70 | $127 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $10 | $10 | $10 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $19 | $65 | $110 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $303 | $303 | $304 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $71 | $211 | $352 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $45 | $74 | $103 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $148 | $148 | $148 |
| EMG needle each extremity complete CPT 95886 • Neurology | $40 | $59 | $77 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $47 | $65 | $83 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $59 | $83 | $107 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $58 | $64 | $70 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $34 | $101 | $168 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $130 | $194 | $258 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $60 | $69 | $77 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $40 | $76 | $112 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $67 | $67 | $67 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $21 | $118 | $216 |
| Office visit established patient minimal CPT 99211 • Office Visits | $4 | $13 | $22 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $34 | $39 | $45 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $40 | $58 | $75 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $6 | $59 | $111 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $91 | $120 | $150 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $8 | $74 | $139 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $11 | $78 | $144 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $182 | $197 | $213 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $61 | $61 | $62 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $76 | $76 | $77 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $13 | $61 | $109 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $76 | $76 | $77 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $88 | $100 | $112 |
| Consultation office low complexity CPT 99243 • Office Visits | $40 | $68 | $95 |
| Consultation office high complexity CPT 99245 • Office Visits | $232 | $232 | $232 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $221 | $357 | $492 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $4 | $17 | $29 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $876 | $876 | $876 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $31 | $35 | $40 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $81 | $446 | $811 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $37 | $206 | $374 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $40 | $104 | $168 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $277 | $277 | $277 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $202 | $202 | $202 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $35 | $35 | $35 |
| Retinal detachment repair with vitrectomy CPT 67108 • Ophthalmology | $621 | $621 | $621 |
| Retinal photocoagulation treatment CPT 67210 • Ophthalmology | $74 | $229 | $384 |