| Psychotherapy 60 minutes CPT 90837 • Mental Health | $136 | $178 | $221 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $125 | $233 | $341 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $177 | $177 | $177 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $92 | $92 | $92 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $102 | $102 | $102 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $124 | $196 | $268 |
| Group psychotherapy CPT 90853 • Mental Health | $34 | $34 | $34 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $7 | $10 | $14 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $326 | $380 | $435 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $273 | $273 | $273 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $210 | $210 | $210 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $212 | $774 | $1,127 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $241 | $241 | $241 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $112 | $112 | $112 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $127 | $127 | $127 |
| EMG needle each extremity complete CPT 95886 • Neurology | $110 | $187 | $265 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $118 | $118 | $118 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $141 | $199 | $311 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $170 | $173 | $175 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $230 | $357 | $485 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $376 | $579 | $783 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $67 | $131 | $195 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $99 | $173 | $247 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $50 | $169 | $316 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $50 | $195 | $393 |
| Office visit established patient minimal CPT 99211 • Office Visits | $23 | $38 | $53 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $39 | $72 | $104 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $55 | $112 | $169 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $50 | $62 | $86 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $124 | $227 | $330 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $68 | $125 | $182 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $113 | $200 | $287 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $157 | $329 | $448 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $34 | $50 | $65 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $56 | $114 | $173 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $79 | $171 | $262 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $72 | $129 | $186 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $98 | $201 | $265 |
| Consultation office low complexity CPT 99243 • Office Visits | $124 | $203 | $277 |
| Consultation office high complexity CPT 99245 • Office Visits | $227 | $227 | $227 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $614 | $1,135 | $1,655 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $75 | $90 | $106 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,455 | $1,984 | $2,513 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $50 | $229 | $409 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,602 | $1,602 | $1,602 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $723 | $723 | $723 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $50 | $247 | $444 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $1,217 | $1,224 | $1,232 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $50 | $514 | $978 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $189 | $194 | $198 |