| Psychotherapy 45 minutes CPT 90834 • Mental Health | $90 | $184 | $326 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $39 | $179 | $299 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $110 | $304 | $501 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $127 | $246 | $379 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $131 | $251 | $461 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $54 | $114 | $228 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $78 | $196 | $327 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $82 | $228 | $340 |
| Group psychotherapy CPT 90853 • Mental Health | $26 | $55 | $99 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $10 | $16 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $49 | $1,124 | $5,449 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $91 | $1,547 | $5,449 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $95 | $1,573 | $5,449 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $95 | $593 | $1,206 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $95 | $666 | $1,398 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $48 | $151 | $358 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $24 | $248 | $535 |
| EMG needle each extremity complete CPT 95886 • Neurology | $51 | $146 | $247 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $37 | $140 | $299 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $98 | $233 | $357 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $65 | $209 | $393 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $67 | $279 | $516 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $157 | $453 | $842 |
| EEG monitoring continuous 24 hours CPT 95950 • Neurology | $116 | $116 | $116 |
| EEG monitoring continuous 24 hours with video CPT 95951 • Neurology | $1,199 | $1,199 | $1,199 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $64 | $125 | $182 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $65 | $162 | $258 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $85 | $275 | $460 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $142 | $380 | $578 |
| Office visit established patient minimal CPT 99211 • Office Visits | $6 | $34 | $64 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $25 | $87 | $117 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $90 | $144 | $185 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $69 | $193 | $309 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $102 | $272 | $365 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $82 | $169 | $285 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $112 | $259 | $384 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $163 | $367 | $566 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $40 | $87 | $176 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $81 | $143 | $203 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $96 | $203 | $292 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $70 | $137 | $203 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $79 | $218 | $300 |
| Consultation office straightforward CPT 99241 • Office Visits | $27 | $54 | $80 |
| Consultation office low complexity CPT 99243 • Office Visits | $51 | $216 | $347 |
| Consultation office high complexity CPT 99245 • Office Visits | $110 | $411 | $624 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $481 | $3,183 | $12,615 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $40 | $86 | $152 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $966 | $4,423 | $15,291 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $189 | $1,695 | $7,278 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,017 | $4,187 | $10,561 |