| Psychotherapy 45 minutes CPT 90834 • Mental Health | $71 | $106 | $171 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $70 | $102 | $157 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $138 | $176 | $239 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $91 | $136 | $207 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $96 | $165 | $267 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $50 | $77 | $119 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $68 | $124 | $206 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $94 | $136 | $214 |
| Group psychotherapy CPT 90853 • Mental Health | $21 | $31 | $47 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $1 | $5 | $9 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $27 | $99 | $147 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $57 | $152 | $247 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $20 | $117 | $203 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $55 | $175 | $360 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $110 | $245 | $417 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $52 | $128 | $224 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $29 | $111 | $157 |
| EMG needle each extremity complete CPT 95886 • Neurology | $44 | $75 | $94 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $33 | $74 | $102 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $21 | $77 | $108 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $50 | $102 | $153 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $33 | $120 | $171 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $92 | $244 | $360 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $6 | $71 | $147 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $61 | $101 | $148 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $14 | $158 | $317 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $29 | $178 | $328 |
| Office visit established patient minimal CPT 99211 • Office Visits | $10 | $24 | $43 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $31 | $42 | $50 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $6 | $75 | $143 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $17 | $94 | $210 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $125 | $186 | $281 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $11 | $93 | $197 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $85 | $155 | $267 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $113 | $219 | $394 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $36 | $52 | $77 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $59 | $90 | $142 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $77 | $128 | $203 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $60 | $90 | $142 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $15 | $107 | $209 |
| Consultation office low complexity CPT 99243 • Office Visits | $54 | $146 | $237 |
| Consultation office high complexity CPT 99245 • Office Visits | $30 | $222 | $434 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $433 | $676 | $1,017 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $4 | $50 | $105 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $885 | $1,454 | $2,217 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $44 | $217 | $389 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $116 | $1,108 | $2,044 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $80 | $605 | $1,200 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $218 | $387 | $555 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $398 | $942 | $1,486 |