| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $86 | $99 | $111 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $102 | $139 | $184 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $103 | $122 | $150 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $98 | $117 | $132 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $73 | $81 | $96 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $76 | $107 | $132 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $89 | $110 | $137 |
| Group psychotherapy CPT 90853 • Mental Health | $40 | $49 | $66 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $5 | $6 | $6 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $9 | $20 | $30 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $132 | $132 | $132 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $11 | $11 | $11 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $74 | $74 | $74 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $86 | $86 | $86 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $22 | $22 | $22 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $80 | $127 | $174 |
| EMG needle each extremity complete CPT 95886 • Neurology | $49 | $73 | $97 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $18 | $53 | $89 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $62 | $62 | $62 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $55 | $101 | $148 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $39 | $107 | $175 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $184 | $184 | $184 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $55 | $79 | $97 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $110 | $129 | $139 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $132 | $164 | $193 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $22 | $182 | $305 |
| Office visit established patient minimal CPT 99211 • Office Visits | $23 | $37 | $53 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $36 | $50 | $57 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $7 | $63 | $104 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $115 | $131 | $148 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $26 | $124 | $176 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $72 | $124 | $170 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $113 | $144 | $188 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $33 | $143 | $200 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $6 | $64 | $129 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $78 | $97 | $129 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $107 | $124 | $137 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $7 | $76 | $129 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $10 | $90 | $132 |
| Consultation office low complexity CPT 99243 • Office Visits | $46 | $79 | $112 |
| Consultation office high complexity CPT 99245 • Office Visits | $208 | $225 | $254 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $30 | $226 | $421 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $30 | $31 | $33 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,131 | $1,131 | $1,131 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $34 | $34 | $34 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $30 | $382 | $733 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $362 | $362 | $362 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $30 | $87 | $144 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $79 | $79 | $79 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $448 | $448 | $448 |