| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $1 | $163 | $298 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $1 | $166 | $336 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $1 | $74 | $141 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $1 | $64 | $130 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $1 | $98 | $186 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $1 | $90 | $165 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $1 | $144 | $276 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $1 | $129 | $219 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $1 | $171 | $265 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $1 | $85 | $130 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $1 | $101 | $175 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $1 | $112 | $183 |
| Group psychotherapy CPT 90853 • Mental Health | $1 | $34 | $50 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $1 | $5 | $8 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $158 | $203 | $256 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $166 | $198 | $241 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $122 | $198 | $272 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $39 | $204 | $577 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $96 | $243 | $673 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $33 | $67 | $107 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $104 | $168 | $298 |
| EMG needle each extremity complete CPT 95886 • Neurology | $40 | $78 | $135 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $26 | $81 | $165 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $51 | $92 | $157 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $40 | $101 | $158 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $74 | $188 | $305 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $129 | $293 | $498 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $56 | $85 | $141 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $61 | $136 | $218 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $101 | $218 | $327 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $132 | $274 | $432 |
| Office visit established patient minimal CPT 99211 • Office Visits | $8 | $30 | $44 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $20 | $63 | $109 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $39 | $118 | $221 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $61 | $158 | $252 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $88 | $224 | $352 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $78 | $152 | $285 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $110 | $210 | $384 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $160 | $302 | $566 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $33 | $63 | $109 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $59 | $114 | $203 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $84 | $164 | $292 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $60 | $115 | $203 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $87 | $167 | $300 |
| Consultation office low complexity CPT 99243 • Office Visits | $85 | $192 | $341 |
| Consultation office high complexity CPT 99245 • Office Visits | $202 | $369 | $624 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $513 | $678 | $963 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $53 | $61 | $73 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,057 | $1,493 | $2,041 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $308 | $370 | $469 |