| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $87 | $252 | $341 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $57 | $75 | $87 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $79 | $101 | $136 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $104 | $146 | $205 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $120 | $187 | $271 |
| Office visit established patient minimal CPT 99211 • Office Visits | $11 | $17 | $23 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $21 | $44 | $68 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $35 | $67 | $111 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $64 | $97 | $157 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $81 | $138 | $220 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $74 | $87 | $111 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $95 | $126 | $159 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $125 | $170 | $212 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $31 | $52 | $87 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $54 | $68 | $87 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $81 | $92 | $107 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $55 | $73 | $87 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $80 | $99 | $110 |
| Consultation office low complexity CPT 99243 • Office Visits | $62 | $101 | $151 |
| Consultation office high complexity CPT 99245 • Office Visits | $120 | $214 | $343 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $340 | $566 | $746 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $21 | $40 | $54 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $563 | $1,029 | $1,418 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $146 | $261 | $345 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $126 | $818 | $1,308 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $301 | $464 | $605 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $340 | $356 | $374 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $731 | $812 | $892 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $589 | $627 | $651 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $131 | $147 | $173 |
| Retinal detachment repair with vitrectomy CPT 67108 • Ophthalmology | $173 | $992 | $1,424 |
| Retinal photocoagulation treatment CPT 67210 • Ophthalmology | $615 | $672 | $721 |
| Retinal treatment extensive photocoagulation CPT 67228 • Ophthalmology | $171 | $504 | $935 |
| Strabismus surgery one horizontal muscle CPT 67311 • Ophthalmology | $456 | $487 | $548 |
| Excision chalazion single CPT 67800 • Ophthalmology | $95 | $121 | $155 |
| Blepharoptosis repair levator resection CPT 67901 • Ophthalmology | $280 | $570 | $939 |
| Lacrimal punctum closure by plug CPT 68761 • Ophthalmology | $108 | $136 | $172 |
| Eye exam new patient intermediate CPT 92002 • Ophthalmology | $38 | $59 | $101 |
| Eye exam new patient comprehensive CPT 92004 • Ophthalmology | $72 | $108 | $178 |
| Eye exam established patient intermediate CPT 92012 • Ophthalmology | $26 | $54 | $106 |
| Eye exam established patient comprehensive CPT 92014 • Ophthalmology | $48 | $86 | $150 |
| Visual field examination CPT 92083 • Ophthalmology | $23 | $32 | $39 |
| Retinal imaging OCT posterior segment CPT 92134 • Ophthalmology | $20 | $30 | $39 |
| Ophthalmic biometry IOL power calculation CPT 92136 • Ophthalmology | $57 | $70 | $81 |
| Fundus photography CPT 92250 • Ophthalmology | $17 | $40 | $58 |
| Arthrocentesis aspiration small joint CPT 20600 • Orthopedics | $34 | $52 | $78 |
| Arthrocentesis aspiration intermediate joint CPT 20605 • Orthopedics | $35 | $63 | $79 |
| Arthrocentesis aspiration major joint CPT 20610 • Orthopedics | $40 | $63 | $94 |
| Cervical spine fusion anterior approach CPT 22551 • Orthopedics | $939 | $1,775 | $2,495 |
| Lumbar spine fusion posterior approach CPT 22612 • Orthopedics | $1,358 | $1,905 | $2,318 |