| Group psychotherapy CPT 90853 • Mental Health | $35 | $41 | $49 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $6 | $8 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $83 | $106 | $159 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $116 | $168 | $199 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $116 | $147 | $198 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $59 | $234 | $526 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $78 | $205 | $421 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $79 | $90 | $108 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $45 | $112 | $166 |
| EMG needle each extremity complete CPT 95886 • Neurology | $46 | $66 | $95 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $49 | $78 | $107 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $76 | $121 | $198 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $65 | $108 | $158 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $91 | $199 | $312 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $216 | $332 | $413 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $40 | $69 | $92 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $87 | $130 | $172 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $129 | $163 | $241 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $30 | $201 | $318 |
| Office visit established patient minimal CPT 99211 • Office Visits | $11 | $21 | $34 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $29 | $53 | $82 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $56 | $83 | $120 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $71 | $127 | $185 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $30 | $171 | $305 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $74 | $112 | $134 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $124 | $149 | $184 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $172 | $230 | $315 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $37 | $55 | $87 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $61 | $84 | $99 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $87 | $126 | $167 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $74 | $88 | $115 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $105 | $118 | $163 |
| Consultation office straightforward CPT 99241 • Office Visits | $46 | $46 | $46 |
| Consultation office low complexity CPT 99243 • Office Visits | $90 | $137 | $167 |
| Consultation office high complexity CPT 99245 • Office Visits | $178 | $242 | $299 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $534 | $657 | $897 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $37 | $57 | $74 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $966 | $1,205 | $1,682 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $236 | $313 | $350 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,019 | $1,309 | $1,757 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $481 | $634 | $862 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $288 | $404 | $491 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $713 | $942 | $1,198 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $520 | $721 | $913 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $108 | $157 | $207 |
| Retinal detachment repair with vitrectomy CPT 67108 • Ophthalmology | $1,139 | $1,484 | $1,687 |
| Retinal photocoagulation treatment CPT 67210 • Ophthalmology | $494 | $679 | $802 |
| Retinal treatment extensive photocoagulation CPT 67228 • Ophthalmology | $294 | $642 | $1,172 |
| Strabismus surgery one horizontal muscle CPT 67311 • Ophthalmology | $458 | $625 | $963 |
| Excision chalazion single CPT 67800 • Ophthalmology | $84 | $118 | $187 |