| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $132 | $165 | $176 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $72 | $86 | $95 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $113 | $141 | $150 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $113 | $141 | $150 |
| Group psychotherapy CPT 90853 • Mental Health | $66 | $74 | $78 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $4 | $4 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $6 | $71 | $123 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $30 | $64 | $131 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $67 | $116 | $133 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $73 | $265 | $366 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $56 | $336 | $429 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $50 | $83 | $111 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $80 | $140 | $161 |
| EMG needle each extremity complete CPT 95886 • Neurology | $49 | $51 | $52 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $18 | $53 | $89 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $65 | $88 | $111 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $56 | $71 | $78 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $71 | $96 | $104 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $143 | $224 | $285 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $5 | $42 | $70 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $8 | $84 | $109 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $122 | $147 | $164 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $30 | $114 | $215 |
| Office visit established patient minimal CPT 99211 • Office Visits | $1 | $13 | $22 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $27 | $38 | $54 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $33 | $54 | $65 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $30 | $89 | $124 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $132 | $157 | $176 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $15 | $96 | $170 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $30 | $106 | $131 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $19 | $111 | $198 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $4 | $73 | $129 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $7 | $74 | $129 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $97 | $99 | $99 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $30 | $96 | $129 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $15 | $82 | $110 |
| Consultation office low complexity CPT 99243 • Office Visits | $14 | $69 | $116 |
| Consultation office high complexity CPT 99245 • Office Visits | $21 | $119 | $213 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $30 | $421 | $601 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $30 | $34 | $37 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $792 | $1,017 | $1,130 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $30 | $135 | $237 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $30 | $583 | $1,047 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $72 | $380 | $482 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $30 | $120 | $288 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $30 | $272 | $715 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $30 | $271 | $521 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $30 | $76 | $109 |
| Retinal detachment repair with vitrectomy CPT 67108 • Ophthalmology | $30 | $721 | $1,141 |
| Retinal photocoagulation treatment CPT 67210 • Ophthalmology | $30 | $315 | $495 |