| Psychotherapy 45 minutes CPT 90834 • Mental Health | $95 | $107 | $130 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $84 | $85 | $87 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $119 | $138 | $157 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $111 | $126 | $144 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $109 | $133 | $176 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $63 | $65 | $67 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $95 | $98 | $100 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $116 | $139 | $150 |
| Group psychotherapy CPT 90853 • Mental Health | $40 | $48 | $52 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $1 | $2 | $4 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $12 | $67 | $122 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $66 | $66 | $66 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $11 | $69 | $128 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $360 | $363 | $367 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $208 | $312 | $417 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $108 | $110 | $111 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $81 | $121 | $161 |
| EMG needle each extremity complete CPT 95886 • Neurology | $97 | $97 | $98 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $38 | $63 | $89 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $22 | $65 | $108 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $127 | $127 | $127 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $175 | $175 | $175 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $184 | $232 | $280 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $59 | $68 | $74 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $11 | $71 | $112 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $122 | $148 | $163 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $27 | $118 | $210 |
| Office visit established patient minimal CPT 99211 • Office Visits | $11 | $16 | $19 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $23 | $44 | $54 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $7 | $56 | $88 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $17 | $72 | $104 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $13 | $111 | $176 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $11 | $74 | $152 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $13 | $86 | $152 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $19 | $118 | $212 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $38 | $64 | $115 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $35 | $71 | $115 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $96 | $103 | $115 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $65 | $89 | $115 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $10 | $78 | $130 |
| Consultation office low complexity CPT 99243 • Office Visits | $9 | $64 | $92 |
| Consultation office high complexity CPT 99245 • Office Visits | $28 | $167 | $272 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $399 | $488 | $577 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $38 | $39 | $41 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $848 | $848 | $848 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $47 | $47 | $47 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $157 | $660 | $1,163 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $362 | $448 | $535 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $29 | $29 | $29 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $597 | $597 | $597 |