| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $83 | $83 | $83 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $93 | $93 | $93 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $195 | $195 | $195 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $86 | $86 | $86 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $100 | $100 | $100 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $151 | $151 | $151 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $306 | $306 | $306 |
| Office visit established patient minimal CPT 99211 • Office Visits | $28 | $28 | $28 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $68 | $68 | $68 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $88 | $88 | $88 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $125 | $125 | $125 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $162 | $162 | $162 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $101 | $101 | $101 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $112 | $112 | $112 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $214 | $214 | $214 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $53 | $53 | $53 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $68 | $68 | $68 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $124 | $124 | $124 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $96 | $96 | $96 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $136 | $136 | $136 |
| Eye exam new patient comprehensive CPT 92004 • Ophthalmology | $128 | $128 | $128 |
| Arthrocentesis aspiration small joint CPT 20600 • Orthopedics | $45 | $45 | $45 |
| Arthrocentesis aspiration intermediate joint CPT 20605 • Orthopedics | $27 | $27 | $27 |
| Arthrocentesis aspiration major joint CPT 20610 • Orthopedics | $58 | $58 | $58 |
| Hip replacement conversion to total CPT 27132 • Orthopedics | $251 | $251 | $251 |
| Closed treatment distal fibula fracture CPT 27786 • Orthopedics | $176 | $176 | $176 |
| Bunionectomy with osteotomy CPT 28296 • Orthopedics | $600 | $600 | $600 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $72 | $72 | $72 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $84 | $84 | $84 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $84 | $84 | $84 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $328 | $328 | $328 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $34 | $34 | $34 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $87 | $87 | $87 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $39 | $39 | $39 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $115 | $115 | $115 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $65 | $65 | $65 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $127 | $127 | $127 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $244 | $244 | $244 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $75 | $75 | $75 |
| Cytopathology concentration technique CPT 88108 • Pathology | $14 | $14 | $14 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $7 | $7 | $7 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $15 | $15 | $15 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $49 | $49 | $49 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $36 | $36 | $36 |
| Special stain group II CPT 88313 • Pathology | $30 | $30 | $30 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $11 | $11 | $11 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $8 | $8 | $8 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $11 | $11 | $11 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $11 | $11 | $11 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $19 | $19 | $19 |