| Psychotherapy 60 minutes CPT 90837 • Mental Health | $140 | $140 | $140 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $130 | $130 | $130 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $157 | $157 | $157 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $75 | $75 | $75 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $121 | $121 | $121 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $118 | $118 | $118 |
| Group psychotherapy CPT 90853 • Mental Health | $30 | $30 | $30 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $5 | $5 | $5 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $159 | $159 | $159 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $143 | $143 | $143 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $116 | $116 | $116 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $320 | $320 | $320 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $64 | $64 | $64 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $130 | $130 | $130 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $94 | $94 | $94 |
| EMG needle each extremity complete CPT 95886 • Neurology | $52 | $52 | $52 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $60 | $60 | $60 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $75 | $75 | $75 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $70 | $70 | $70 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $210 | $210 | $210 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $329 | $329 | $329 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $55 | $71 | $87 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $116 | $122 | $128 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $178 | $190 | $197 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $205 | $225 | $247 |
| Office visit established patient minimal CPT 99211 • Office Visits | $10 | $10 | $10 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $28 | $39 | $51 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $80 | $82 | $84 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $118 | $124 | $127 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $158 | $165 | $172 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $110 | $116 | $122 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $150 | $160 | $171 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $221 | $240 | $250 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $43 | $47 | $51 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $80 | $80 | $80 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $114 | $114 | $114 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $80 | $80 | $80 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $117 | $117 | $117 |
| Consultation office low complexity CPT 99243 • Office Visits | $105 | $105 | $105 |
| Consultation office high complexity CPT 99245 • Office Visits | $244 | $244 | $244 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $661 | $661 | $661 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $61 | $61 | $61 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,292 | $1,292 | $1,292 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $268 | $268 | $268 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,191 | $1,191 | $1,191 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $699 | $699 | $699 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $323 | $323 | $323 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $866 | $866 | $866 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $696 | $696 | $696 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $111 | $111 | $111 |