| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $150 | $163 | $177 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $62 | $72 | $82 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $130 | $130 | $130 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $157 | $157 | $158 |
| Group psychotherapy CPT 90853 • Mental Health | $50 | $59 | $67 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $4 | $4 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $61 | $92 | $123 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $11 | $11 | $11 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $79 | $106 | $133 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $56 | $183 | $310 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $374 | $401 | $429 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $50 | $81 | $111 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $32 | $97 | $161 |
| EMG needle each extremity complete CPT 95886 • Neurology | $97 | $97 | $98 |
| 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 | $27 | $52 | $78 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $71 | $123 | $175 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $57 | $171 | $285 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $59 | $68 | $78 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $12 | $65 | $117 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $81 | $107 | $132 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $90 | $90 | $90 |
| Office visit established patient minimal CPT 99211 • Office Visits | $3 | $13 | $22 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $41 | $48 | $54 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $10 | $49 | $88 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $14 | $70 | $125 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $132 | $141 | $149 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $110 | $129 | $147 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $159 | $159 | $159 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $166 | $194 | $221 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $38 | $74 | $111 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $69 | $90 | $111 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $95 | $103 | $111 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $35 | $73 | $111 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $10 | $73 | $136 |
| Consultation office low complexity CPT 99243 • Office Visits | $14 | $74 | $134 |
| Consultation office high complexity CPT 99245 • Office Visits | $28 | $156 | $285 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $373 | $487 | $601 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $26 | $32 | $37 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,130 | $1,130 | $1,131 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $166 | $166 | $166 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $786 | $916 | $1,047 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $362 | $422 | $482 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $159 | $159 | $159 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $358 | $358 | $358 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $261 | $261 | $261 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $44 | $44 | $44 |
| Retinal detachment repair with vitrectomy CPT 67108 • Ophthalmology | $114 | $114 | $114 |
| Retinal photocoagulation treatment CPT 67210 • Ophthalmology | $495 | $495 | $495 |