| Psychotherapy 60 minutes CPT 90837 • Mental Health | $90 | $156 | $222 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $77 | $77 | $77 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $94 | $94 | $94 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $45 | $45 | $45 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $67 | $119 | $156 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $69 | $69 | $69 |
| Group psychotherapy CPT 90853 • Mental Health | $16 | $16 | $16 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $3 | $4 | $5 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $85 | $85 | $85 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $75 | $75 | $75 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $86 | $86 | $86 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $211 | $211 | $211 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $213 | $213 | $213 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $72 | $72 | $72 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $104 | $104 | $104 |
| EMG needle each extremity complete CPT 95886 • Neurology | $30 | $30 | $30 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $35 | $35 | $35 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $74 | $74 | $74 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $89 | $89 | $89 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $47 | $47 | $47 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $186 | $186 | $186 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $47 | $78 | $94 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $67 | $99 | $131 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $103 | $156 | $205 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $131 | $199 | $266 |
| Office visit established patient minimal CPT 99211 • Office Visits | $14 | $21 | $27 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $28 | $45 | $66 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $33 | $64 | $79 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $68 | $110 | $150 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $91 | $151 | $211 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $66 | $66 | $66 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $89 | $89 | $89 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $130 | $130 | $130 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $25 | $25 | $25 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $47 | $47 | $47 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $67 | $67 | $67 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $47 | $47 | $47 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $68 | $68 | $68 |
| Consultation office low complexity CPT 99243 • Office Visits | $78 | $78 | $78 |
| Consultation office high complexity CPT 99245 • Office Visits | $125 | $125 | $125 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $340 | $340 | $340 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $23 | $23 | $23 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $740 | $740 | $740 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $153 | $153 | $153 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $678 | $678 | $678 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $309 | $309 | $309 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $183 | $183 | $183 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $468 | $468 | $468 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $340 | $340 | $340 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $63 | $63 | $63 |