| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $122 | $143 | $163 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $51 | $56 | $61 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $75 | $86 | $97 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $69 | $113 | $157 |
| Group psychotherapy CPT 90853 • Mental Health | $47 | $48 | $48 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $6 | $6 | $6 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $56 | $56 | $56 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $18 | $18 | $18 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $18 | $18 | $18 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $252 | $302 | $351 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $58 | $58 | $58 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $47 | $47 | $47 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $28 | $28 | $28 |
| EMG needle each extremity complete CPT 95886 • Neurology | $43 | $43 | $43 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $48 | $48 | $48 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $129 | $129 | $129 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $23 | $23 | $23 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $31 | $31 | $31 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $47 | $47 | $47 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $39 | $49 | $59 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $89 | $105 | $120 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $10 | $79 | $148 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $136 | $156 | $175 |
| Office visit established patient minimal CPT 99211 • Office Visits | $22 | $32 | $42 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $20 | $32 | $44 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $6 | $58 | $110 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $85 | $122 | $160 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $93 | $133 | $173 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $6 | $6 | $6 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $10 | $10 | $10 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $190 | $190 | $190 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $62 | $62 | $62 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $62 | $89 | $116 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $39 | $39 | $39 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $46 | $46 | $46 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $43 | $43 | $43 |
| Consultation office low complexity CPT 99243 • Office Visits | $9 | $9 | $9 |
| Consultation office high complexity CPT 99245 • Office Visits | $19 | $19 | $19 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $333 | $333 | $333 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $6 | $6 | $6 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $657 | $657 | $657 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $107 | $107 | $107 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $406 | $406 | $406 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $37 | $37 | $37 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $171 | $171 | $171 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $120 | $120 | $120 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $81 | $81 | $81 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $14 | $14 | $14 |
| Retinal detachment repair with vitrectomy CPT 67108 • Ophthalmology | $45 | $45 | $45 |
| Retinal photocoagulation treatment CPT 67210 • Ophthalmology | $185 | $185 | $185 |