| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $132 | $359 | $694 |
| EEG monitoring continuous 24 hours CPT 95950 • Neurology | $642 | $642 | $642 |
| EEG monitoring continuous 24 hours with video CPT 95951 • Neurology | $905 | $905 | $905 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $48 | $83 | $150 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $73 | $159 | $318 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $85 | $257 | $477 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $142 | $296 | $627 |
| Office visit established patient minimal CPT 99211 • Office Visits | $6 | $31 | $68 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $32 | $66 | $117 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $30 | $120 | $264 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $30 | $146 | $366 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $95 | $271 | $515 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $30 | $146 | $287 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $112 | $198 | $364 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $147 | $269 | $483 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $37 | $65 | $113 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $30 | $103 | $220 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $30 | $163 | $331 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $30 | $112 | $228 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $94 | $172 | $321 |
| Consultation office straightforward CPT 99241 • Office Visits | $46 | $63 | $80 |
| Consultation office low complexity CPT 99243 • Office Visits | $30 | $158 | $320 |
| Consultation office high complexity CPT 99245 • Office Visits | $142 | $329 | $595 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $551 | $927 | $2,071 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $24 | $65 | $129 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $663 | $2,072 | $4,399 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $245 | $434 | $922 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $30 | $1,704 | $4,101 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $483 | $935 | $1,769 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $267 | $484 | $991 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $723 | $1,319 | $2,781 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $30 | $933 | $1,884 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $30 | $187 | $425 |
| Retinal detachment repair with vitrectomy CPT 67108 • Ophthalmology | $30 | $2,096 | $4,418 |
| Retinal photocoagulation treatment CPT 67210 • Ophthalmology | $30 | $823 | $1,707 |
| Retinal treatment extensive photocoagulation CPT 67228 • Ophthalmology | $340 | $727 | $1,192 |
| Strabismus surgery one horizontal muscle CPT 67311 • Ophthalmology | $481 | $956 | $2,080 |
| Excision chalazion single CPT 67800 • Ophthalmology | $30 | $230 | $488 |
| Blepharoptosis repair levator resection CPT 67901 • Ophthalmology | $522 | $1,219 | $2,251 |
| Lacrimal punctum closure by plug CPT 68761 • Ophthalmology | $129 | $283 | $554 |
| Eye exam new patient intermediate CPT 92002 • Ophthalmology | $46 | $126 | $236 |
| Eye exam new patient comprehensive CPT 92004 • Ophthalmology | $62 | $206 | $565 |
| Eye exam established patient intermediate CPT 92012 • Ophthalmology | $31 | $110 | $210 |
| Eye exam established patient comprehensive CPT 92014 • Ophthalmology | $48 | $205 | $479 |
| Visual field examination CPT 92083 • Ophthalmology | $62 | $77 | $99 |
| Retinal imaging OCT posterior segment CPT 92134 • Ophthalmology | $13 | $44 | $92 |
| Ophthalmic biometry IOL power calculation CPT 92136 • Ophthalmology | $26 | $73 | $175 |
| Fundus photography CPT 92250 • Ophthalmology | $20 | $49 | $90 |
| Arthrocentesis aspiration small joint CPT 20600 • Orthopedics | $47 | $93 | $177 |
| Arthrocentesis aspiration intermediate joint CPT 20605 • Orthopedics | $30 | $82 | $184 |