| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $57 | $332 | $774 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $58 | $371 | $903 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $52 | $112 | $214 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $69 | $140 | $297 |
| EMG needle each extremity complete CPT 95886 • Neurology | $40 | $93 | $181 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $37 | $88 | $169 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $67 | $125 | $211 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $54 | $131 | $254 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $139 | $207 | $331 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $176 | $305 | $539 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $57 | $71 | $85 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $73 | $103 | $147 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $129 | $184 | $240 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $142 | $202 | $327 |
| Office visit established patient minimal CPT 99211 • Office Visits | $10 | $16 | $23 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $25 | $43 | $64 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $56 | $77 | $119 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $71 | $122 | $175 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $114 | $159 | $260 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $74 | $108 | $147 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $112 | $149 | $234 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $147 | $208 | $311 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $37 | $60 | $88 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $61 | $85 | $142 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $87 | $129 | $212 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $64 | $90 | $147 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $94 | $124 | $208 |
| Consultation office low complexity CPT 99243 • Office Visits | $73 | $108 | $131 |
| Consultation office high complexity CPT 99245 • Office Visits | $221 | $233 | $246 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $534 | $696 | $1,038 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $24 | $45 | $66 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $663 | $1,248 | $2,187 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $166 | $273 | $379 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $194 | $1,074 | $2,042 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $481 | $725 | $1,208 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $230 | $318 | $440 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $526 | $833 | $1,382 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $520 | $783 | $1,209 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $99 | $135 | $173 |
| Retinal detachment repair with vitrectomy CPT 67108 • Ophthalmology | $227 | $1,222 | $2,192 |
| Retinal photocoagulation treatment CPT 67210 • Ophthalmology | $494 | $687 | $930 |
| Retinal treatment extensive photocoagulation CPT 67228 • Ophthalmology | $245 | $480 | $935 |
| Strabismus surgery one horizontal muscle CPT 67311 • Ophthalmology | $458 | $627 | $853 |
| Excision chalazion single CPT 67800 • Ophthalmology | $82 | $123 | $191 |
| Blepharoptosis repair levator resection CPT 67901 • Ophthalmology | $458 | $716 | $1,101 |
| Lacrimal punctum closure by plug CPT 68761 • Ophthalmology | $108 | $152 | $222 |
| Eye exam new patient intermediate CPT 92002 • Ophthalmology | $38 | $62 | $82 |
| Eye exam new patient comprehensive CPT 92004 • Ophthalmology | $72 | $143 | $185 |
| Eye exam established patient intermediate CPT 92012 • Ophthalmology | $30 | $65 | $91 |
| Eye exam established patient comprehensive CPT 92014 • Ophthalmology | $48 | $95 | $137 |