| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $132 | $141 | $150 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $63 | $64 | $65 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $82 | $91 | $99 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $103 | $103 | $104 |
| Group psychotherapy CPT 90853 • Mental Health | $29 | $37 | $46 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $3 | $3 | $3 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $45 | $45 | $45 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $45 | $56 | $68 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $118 | $118 | $118 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $376 | $376 | $376 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $46 | $46 | $46 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $41 | $41 | $41 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $87 | $129 | $172 |
| EMG needle each extremity complete CPT 95886 • Neurology | $104 | $104 | $104 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $42 | $42 | $42 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $24 | $24 | $24 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $85 | $85 | $85 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $77 | $77 | $77 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $149 | $149 | $149 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $7 | $7 | $7 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $45 | $53 | $62 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $10 | $78 | $146 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $170 | $170 | $170 |
| Office visit established patient minimal CPT 99211 • Office Visits | $8 | $26 | $45 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $31 | $38 | $45 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $45 | $51 | $57 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $95 | $106 | $116 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $16 | $31 | $45 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $45 | $63 | $81 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $45 | $66 | $87 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $45 | $99 | $154 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $37 | $41 | $45 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $45 | $53 | $62 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $16 | $30 | $45 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $7 | $26 | $45 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $77 | $77 | $77 |
| Consultation office low complexity CPT 99243 • Office Visits | $34 | $54 | $73 |
| Consultation office high complexity CPT 99245 • Office Visits | $20 | $33 | $45 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $45 | $65 | $85 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $4 | $25 | $45 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $657 | $767 | $876 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $29 | $29 | $29 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $45 | $669 | $1,293 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $37 | $37 | $37 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $168 | $168 | $168 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $615 | $615 | $615 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $321 | $321 | $321 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $85 | $85 | $85 |
| Retinal detachment repair with vitrectomy CPT 67108 • Ophthalmology | $698 | $1,047 | $1,396 |
| Retinal photocoagulation treatment CPT 67210 • Ophthalmology | $45 | $215 | $384 |