| Psychotherapy 45 minutes CPT 90834 • Mental Health | $65 | $102 | $130 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $51 | $75 | $116 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $84 | $115 | $147 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $68 | $99 | $121 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $92 | $120 | $147 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $46 | $71 | $96 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $61 | $100 | $150 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $64 | $107 | $150 |
| Group psychotherapy CPT 90853 • Mental Health | $17 | $20 | $23 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $3 | $3 | $3 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $40 | $40 | $40 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $30 | $53 | $76 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $88 | $111 | $134 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $35 | $201 | $367 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $251 | $364 | $476 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $39 | $94 | $134 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $100 | $140 | $161 |
| EMG needle each extremity complete CPT 95886 • Neurology | $28 | $28 | $28 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $33 | $76 | $107 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $41 | $95 | $136 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $49 | $91 | $134 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $45 | $145 | $215 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $179 | $269 | $342 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $46 | $58 | $71 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $51 | $51 | $51 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $105 | $137 | $164 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $113 | $146 | $180 |
| Office visit established patient minimal CPT 99211 • Office Visits | $15 | $22 | $30 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $22 | $38 | $55 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $30 | $44 | $57 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $30 | $74 | $110 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $114 | $114 | $114 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $30 | $41 | $52 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $81 | $81 | $81 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $16 | $62 | $108 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $31 | $31 | $31 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $30 | $40 | $49 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $30 | $52 | $74 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $30 | $40 | $51 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $71 | $91 | $110 |
| Consultation office low complexity CPT 99243 • Office Visits | $30 | $48 | $71 |
| Consultation office high complexity CPT 99245 • Office Visits | $21 | $77 | $132 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $392 | $392 | $392 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $24 | $24 | $24 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $734 | $937 | $1,140 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $153 | $153 | $153 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $30 | $356 | $682 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $317 | $400 | $483 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $187 | $187 | $187 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $464 | $464 | $464 |