| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $111 | $111 | $111 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $237 | $237 | $237 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $312 | $312 | $312 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $311 | $311 | $311 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $85 | $85 | $85 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $178 | $178 | $178 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $272 | $272 | $272 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $284 | $284 | $284 |
| Office visit established patient minimal CPT 99211 • Office Visits | $15 | $15 | $15 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $75 | $75 | $75 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $123 | $123 | $123 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $178 | $178 | $178 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $240 | $240 | $240 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $172 | $172 | $172 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $230 | $230 | $230 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $336 | $336 | $336 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $66 | $66 | $66 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $120 | $120 | $120 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $172 | $172 | $172 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $121 | $121 | $121 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $177 | $177 | $177 |
| Consultation office low complexity CPT 99243 • Office Visits | $162 | $162 | $162 |
| Consultation office high complexity CPT 99245 • Office Visits | $375 | $375 | $375 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $1,150 | $1,150 | $1,150 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $68 | $68 | $68 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $2,212 | $2,212 | $2,212 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $389 | $389 | $389 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $2,040 | $2,040 | $2,040 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $936 | $936 | $936 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $557 | $557 | $557 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $1,401 | $1,401 | $1,401 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $1,020 | $1,020 | $1,020 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $185 | $185 | $185 |
| Retinal detachment repair with vitrectomy CPT 67108 • Ophthalmology | $2,240 | $2,240 | $2,240 |
| Retinal photocoagulation treatment CPT 67210 • Ophthalmology | $966 | $966 | $966 |
| Retinal treatment extensive photocoagulation CPT 67228 • Ophthalmology | $571 | $571 | $571 |
| Strabismus surgery one horizontal muscle CPT 67311 • Ophthalmology | $1,114 | $1,114 | $1,114 |
| Excision chalazion single CPT 67800 • Ophthalmology | $240 | $240 | $240 |
| Blepharoptosis repair levator resection CPT 67901 • Ophthalmology | $1,454 | $1,454 | $1,454 |
| Lacrimal punctum closure by plug CPT 68761 • Ophthalmology | $275 | $275 | $275 |
| Eye exam new patient intermediate CPT 92002 • Ophthalmology | $108 | $108 | $108 |
| Eye exam new patient comprehensive CPT 92004 • Ophthalmology | $127 | $127 | $127 |
| Eye exam established patient intermediate CPT 92012 • Ophthalmology | $68 | $68 | $68 |
| Eye exam established patient comprehensive CPT 92014 • Ophthalmology | $163 | $163 | $163 |
| Visual field examination CPT 92083 • Ophthalmology | $81 | $81 | $81 |
| Retinal imaging OCT posterior segment CPT 92134 • Ophthalmology | $33 | $33 | $33 |
| Ophthalmic biometry IOL power calculation CPT 92136 • Ophthalmology | $40 | $40 | $40 |
| Fundus photography CPT 92250 • Ophthalmology | $28 | $28 | $28 |
| Arthrocentesis aspiration small joint CPT 20600 • Orthopedics | $97 | $97 | $97 |
| Arthrocentesis aspiration intermediate joint CPT 20605 • Orthopedics | $100 | $100 | $100 |