| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $163 | $330 | $445 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $60 | $80 | $101 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $80 | $169 | $273 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $185 | $275 | $409 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $237 | $287 | $317 |
| Office visit established patient minimal CPT 99211 • Office Visits | $31 | $33 | $35 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $41 | $60 | $81 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $107 | $121 | $130 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $115 | $202 | $312 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $250 | $322 | $440 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $118 | $133 | $143 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $161 | $179 | $192 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $237 | $264 | $281 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $47 | $53 | $58 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $98 | $102 | $106 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $123 | $136 | $145 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $84 | $97 | $108 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $124 | $142 | $158 |
| Consultation office low complexity CPT 99243 • Office Visits | $0 | $106 | $166 |
| Consultation office high complexity CPT 99245 • Office Visits | $0 | $244 | $430 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $862 | $1,241 | $1,462 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $58 | $95 | $149 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,450 | $1,879 | $2,573 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $200 | $379 | $594 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $30 | $1,043 | $1,594 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $466 | $548 | $697 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $344 | $444 | $569 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $682 | $1,147 | $1,733 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $748 | $994 | $1,393 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $141 | $174 | $222 |
| Retinal detachment repair with vitrectomy CPT 67108 • Ophthalmology | $241 | $1,568 | $2,826 |
| Retinal photocoagulation treatment CPT 67210 • Ophthalmology | $486 | $610 | $713 |
| Retinal treatment extensive photocoagulation CPT 67228 • Ophthalmology | $440 | $551 | $742 |
| Strabismus surgery one horizontal muscle CPT 67311 • Ophthalmology | $664 | $930 | $1,303 |
| Excision chalazion single CPT 67800 • Ophthalmology | $149 | $201 | $276 |
| Blepharoptosis repair levator resection CPT 67901 • Ophthalmology | $30 | $562 | $1,117 |
| Lacrimal punctum closure by plug CPT 68761 • Ophthalmology | $115 | $215 | $321 |
| Eye exam new patient intermediate CPT 92002 • Ophthalmology | $55 | $121 | $176 |
| Eye exam new patient comprehensive CPT 92004 • Ophthalmology | $55 | $180 | $322 |
| Eye exam established patient intermediate CPT 92012 • Ophthalmology | $55 | $109 | $185 |
| Eye exam established patient comprehensive CPT 92014 • Ophthalmology | $55 | $174 | $268 |
| Visual field examination CPT 92083 • Ophthalmology | $51 | $94 | $139 |
| Retinal imaging OCT posterior segment CPT 92134 • Ophthalmology | $22 | $60 | $98 |
| Ophthalmic biometry IOL power calculation CPT 92136 • Ophthalmology | $34 | $91 | $195 |
| Fundus photography CPT 92250 • Ophthalmology | $25 | $75 | $171 |
| Arthrocentesis aspiration small joint CPT 20600 • Orthopedics | $72 | $89 | $117 |
| Arthrocentesis aspiration intermediate joint CPT 20605 • Orthopedics | $75 | $107 | $123 |
| Arthrocentesis aspiration major joint CPT 20610 • Orthopedics | $71 | $102 | $146 |
| Cervical spine fusion anterior approach CPT 22551 • Orthopedics | $1,691 | $2,093 | $2,365 |
| Lumbar spine fusion posterior approach CPT 22612 • Orthopedics | $1,569 | $2,488 | $3,687 |