| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $79 | $103 | $116 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $102 | $143 | $184 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $88 | $109 | $123 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $118 | $129 | $140 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $56 | $70 | $96 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $83 | $120 | $150 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $85 | $111 | $150 |
| Group psychotherapy CPT 90853 • Mental Health | $24 | $51 | $77 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $4 | $4 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $30 | $82 | $135 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $30 | $69 | $109 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $134 | $141 | $151 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $349 | $366 | $383 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $350 | $400 | $451 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $45 | $95 | $128 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $72 | $131 | $161 |
| EMG needle each extremity complete CPT 95886 • Neurology | $38 | $76 | $114 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $33 | $76 | $106 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $55 | $100 | $134 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $118 | $126 | $134 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $88 | $158 | $211 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $94 | $240 | $340 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $61 | $69 | $75 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $61 | $93 | $125 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $30 | $100 | $164 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $199 | $207 | $216 |
| Office visit established patient minimal CPT 99211 • Office Visits | $21 | $31 | $36 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $21 | $29 | $36 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $36 | $66 | $102 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $36 | $63 | $116 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $118 | $160 | $203 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $30 | $68 | $100 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $117 | $135 | $152 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $164 | $193 | $224 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $30 | $31 | $32 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $30 | $40 | $59 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $30 | $84 | $115 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $30 | $54 | $72 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $103 | $117 | $130 |
| Consultation office low complexity CPT 99243 • Office Visits | $30 | $66 | $103 |
| Consultation office high complexity CPT 99245 • Office Visits | $163 | $209 | $255 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $30 | $329 | $628 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $30 | $34 | $37 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $958 | $958 | $958 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $168 | $168 | $168 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $30 | $315 | $886 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $408 | $481 | $554 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $191 | $209 | $226 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $742 | $742 | $742 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $30 | $236 | $443 |