| Interactive complexity add-on CPT 90785 • Mental Health | $10 | $18 | $36 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $223 | $304 | $339 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $186 | $277 | $363 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $72 | $129 | $163 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $89 | $110 | $166 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $87 | $166 | $217 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $116 | $159 | $209 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $142 | $242 | $324 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $151 | $229 | $277 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $298 | $318 | $339 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $143 | $151 | $162 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $105 | $199 | $263 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $107 | $225 | $271 |
| Group psychotherapy CPT 90853 • Mental Health | $44 | $60 | $71 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $8 | $13 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $70 | $291 | $511 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $271 | $354 | $436 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $264 | $327 | $390 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $80 | $465 | $851 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $80 | $113 | $145 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $296 | $296 | $296 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $208 | $208 | $208 |
| EMG needle each extremity complete CPT 95886 • Neurology | $107 | $119 | $131 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $134 | $134 | $134 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $120 | $142 | $164 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $112 | $229 | $345 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $147 | $301 | $454 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $277 | $345 | $412 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $53 | $100 | $144 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $106 | $154 | $210 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $30 | $182 | $323 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $20 | $207 | $334 |
| Office visit established patient minimal CPT 99211 • Office Visits | $17 | $29 | $39 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $42 | $62 | $84 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $58 | $109 | $142 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $91 | $134 | $210 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $132 | $204 | $281 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $137 | $169 | $200 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $189 | $230 | $272 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $347 | $374 | $401 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $53 | $65 | $78 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $127 | $135 | $143 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $183 | $194 | $205 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $85 | $114 | $143 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $147 | $179 | $211 |
| Consultation office straightforward CPT 99241 • Office Visits | $50 | $50 | $50 |
| Consultation office low complexity CPT 99243 • Office Visits | $165 | $179 | $194 |
| Consultation office high complexity CPT 99245 • Office Visits | $308 | $376 | $445 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $1,678 | $1,678 | $1,678 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $226 | $226 | $226 |