| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $156 | $156 | $156 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $111 | $156 | $201 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $134 | $187 | $240 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $315 | $315 | $315 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $285 | $389 | $494 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $78 | $101 | $123 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $117 | $146 | $175 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $170 | $218 | $267 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $335 | $335 | $335 |
| Office visit established patient minimal CPT 99211 • Office Visits | $22 | $29 | $36 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $54 | $63 | $73 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $88 | $104 | $120 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $124 | $150 | $176 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $149 | $193 | $236 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $147 | $156 | $166 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $159 | $192 | $224 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $221 | $276 | $331 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $65 | $88 | $111 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $111 | $115 | $119 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $111 | $141 | $170 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $111 | $115 | $119 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $136 | $156 | $175 |
| Consultation office low complexity CPT 99243 • Office Visits | $158 | $179 | $200 |
| Consultation office high complexity CPT 99245 • Office Visits | $285 | $325 | $365 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $1,023 | $1,023 | $1,023 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $94 | $94 | $94 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,996 | $1,996 | $1,996 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $414 | $414 | $414 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,841 | $1,841 | $1,841 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $1,081 | $1,081 | $1,081 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $500 | $500 | $500 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $1,338 | $1,338 | $1,338 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $1,076 | $1,076 | $1,076 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $171 | $171 | $171 |
| Retinal detachment repair with vitrectomy CPT 67108 • Ophthalmology | $2,023 | $2,023 | $2,023 |
| Retinal photocoagulation treatment CPT 67210 • Ophthalmology | $870 | $870 | $870 |
| Retinal treatment extensive photocoagulation CPT 67228 • Ophthalmology | $576 | $576 | $576 |
| Strabismus surgery one horizontal muscle CPT 67311 • Ophthalmology | $1,004 | $1,004 | $1,004 |
| Excision chalazion single CPT 67800 • Ophthalmology | $215 | $215 | $215 |
| Blepharoptosis repair levator resection CPT 67901 • Ophthalmology | $1,289 | $1,289 | $1,289 |
| Lacrimal punctum closure by plug CPT 68761 • Ophthalmology | $248 | $248 | $248 |
| Eye exam new patient intermediate CPT 92002 • Ophthalmology | $136 | $136 | $136 |
| Eye exam new patient comprehensive CPT 92004 • Ophthalmology | $245 | $245 | $245 |
| Eye exam established patient intermediate CPT 92012 • Ophthalmology | $143 | $143 | $143 |
| Eye exam established patient comprehensive CPT 92014 • Ophthalmology | $205 | $205 | $205 |
| Visual field examination CPT 92083 • Ophthalmology | $60 | $82 | $103 |
| Retinal imaging OCT posterior segment CPT 92134 • Ophthalmology | $39 | $53 | $67 |
| Ophthalmic biometry IOL power calculation CPT 92136 • Ophthalmology | $48 | $80 | $113 |
| Fundus photography CPT 92250 • Ophthalmology | $35 | $58 | $82 |
| Arthrocentesis aspiration small joint CPT 20600 • Orthopedics | $81 | $81 | $81 |