| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $141 | $243 | $343 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $149 | $249 | $384 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $59 | $101 | $163 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $49 | $83 | $110 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $89 | $139 | $217 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $81 | $108 | $140 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $134 | $193 | $326 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $128 | $144 | $184 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $168 | $221 | $340 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $76 | $102 | $163 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $89 | $138 | $263 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $106 | $144 | $273 |
| Group psychotherapy CPT 90853 • Mental Health | $28 | $47 | $103 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $8 | $12 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $70 | $212 | $407 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $155 | $192 | $308 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $146 | $175 | $315 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $56 | $366 | $585 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $52 | $333 | $583 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $49 | $110 | $275 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $38 | $145 | $262 |
| EMG needle each extremity complete CPT 95886 • Neurology | $41 | $127 | $242 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $44 | $107 | $220 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $48 | $128 | $274 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $61 | $156 | $329 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $96 | $241 | $430 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $105 | $336 | $695 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $45 | $91 | $165 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $76 | $131 | $255 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $85 | $203 | $381 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $151 | $262 | $508 |
| Office visit established patient minimal CPT 99211 • Office Visits | $8 | $31 | $67 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $23 | $62 | $128 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $45 | $102 | $207 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $85 | $136 | $292 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $100 | $235 | $412 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $82 | $129 | $228 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $98 | $165 | $307 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $172 | $249 | $451 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $38 | $59 | $88 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $66 | $98 | $162 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $92 | $135 | $233 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $65 | $98 | $163 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $95 | $137 | $238 |
| Consultation office straightforward CPT 99241 • Office Visits | $80 | $80 | $80 |
| Consultation office low complexity CPT 99243 • Office Visits | $0 | $156 | $273 |
| Consultation office high complexity CPT 99245 • Office Visits | $0 | $327 | $546 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $590 | $786 | $1,223 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $42 | $58 | $68 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $726 | $1,278 | $2,036 |