| EMG needle each extremity complete CPT 95886 • Neurology | $97 | $97 | $97 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $52 | $70 | $87 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $22 | $67 | $111 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $134 | $134 | $134 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $171 | $173 | $175 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $285 | $285 | $285 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $71 | $74 | $78 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $117 | $117 | $117 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $163 | $163 | $163 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $222 | $222 | $222 |
| Office visit established patient minimal CPT 99211 • Office Visits | $22 | $22 | $22 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $36 | $45 | $54 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $88 | $88 | $88 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $125 | $125 | $125 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $149 | $149 | $149 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $147 | $147 | $147 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $159 | $159 | $159 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $29 | $125 | $221 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $111 | $111 | $111 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $111 | $111 | $112 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $111 | $111 | $112 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $111 | $111 | $112 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $136 | $136 | $136 |
| Consultation office low complexity CPT 99243 • Office Visits | $116 | $137 | $159 |
| Consultation office high complexity CPT 99245 • Office Visits | $285 | $285 | $285 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $548 | $548 | $548 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $39 | $39 | $39 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,048 | $1,080 | $1,112 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $483 | $497 | $511 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $522 | $522 | $522 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $109 | $112 | $115 |
| Retinal detachment repair with vitrectomy CPT 67108 • Ophthalmology | $1,142 | $1,142 | $1,142 |
| Retinal photocoagulation treatment CPT 67210 • Ophthalmology | $495 | $510 | $525 |
| Retinal treatment extensive photocoagulation CPT 67228 • Ophthalmology | $346 | $348 | $349 |
| Strabismus surgery one horizontal muscle CPT 67311 • Ophthalmology | $463 | $463 | $463 |
| Excision chalazion single CPT 67800 • Ophthalmology | $15 | $15 | $15 |
| Blepharoptosis repair levator resection CPT 67901 • Ophthalmology | $566 | $669 | $772 |
| Lacrimal punctum closure by plug CPT 68761 • Ophthalmology | $142 | $142 | $142 |
| Eye exam new patient intermediate CPT 92002 • Ophthalmology | $89 | $89 | $89 |
| Eye exam established patient intermediate CPT 92012 • Ophthalmology | $86 | $86 | $86 |
| Eye exam established patient comprehensive CPT 92014 • Ophthalmology | $122 | $122 | $122 |
| Visual field examination CPT 92083 • Ophthalmology | $26 | $26 | $26 |
| Retinal imaging OCT posterior segment CPT 92134 • Ophthalmology | $14 | $27 | $39 |
| Ophthalmic biometry IOL power calculation CPT 92136 • Ophthalmology | $48 | $48 | $48 |
| Fundus photography CPT 92250 • Ophthalmology | $21 | $28 | $35 |
| Arthrocentesis aspiration intermediate joint CPT 20605 • Orthopedics | $5 | $5 | $5 |
| Arthrocentesis aspiration major joint CPT 20610 • Orthopedics | $63 | $63 | $63 |
| Cervical spine fusion anterior approach CPT 22551 • Orthopedics | $1,781 | $1,781 | $1,781 |
| Lumbar spine fusion posterior approach CPT 22612 • Orthopedics | $1,657 | $1,657 | $1,657 |
| Lumbar spine fusion combined approach CPT 22633 • Orthopedics | $1,801 | $1,801 | $1,801 |