| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $123 | $332 | $896 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $106 | $304 | $896 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $144 | $346 | $479 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $163 | $398 | $546 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $79 | $115 | $168 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $92 | $156 | $236 |
| EMG needle each extremity complete CPT 95886 • Neurology | $37 | $76 | $125 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $37 | $92 | $134 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $41 | $97 | $171 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $117 | $159 | $203 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $153 | $210 | $270 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $102 | $253 | $409 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $57 | $81 | $107 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $80 | $108 | $156 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $105 | $164 | $238 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $144 | $207 | $300 |
| Office visit established patient minimal CPT 99211 • Office Visits | $11 | $20 | $28 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $29 | $50 | $62 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $47 | $85 | $126 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $71 | $114 | $155 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $102 | $135 | $210 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $74 | $147 | $218 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $112 | $145 | $202 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $163 | $211 | $299 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $37 | $45 | $57 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $61 | $97 | $154 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $87 | $141 | $222 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $70 | $103 | $156 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $106 | $126 | $157 |
| Consultation office low complexity CPT 99243 • Office Visits | $51 | $106 | $180 |
| Consultation office high complexity CPT 99245 • Office Visits | $178 | $306 | $412 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $517 | $1,566 | $4,824 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $35 | $243 | $896 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,092 | $5,616 | $18,765 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $189 | $826 | $2,723 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $180 | $2,965 | $10,502 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $422 | $3,134 | $10,502 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $374 | $1,154 | $2,723 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $641 | $3,340 | $10,502 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $437 | $3,176 | $10,502 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $89 | $352 | $896 |
| Retinal detachment repair with vitrectomy CPT 67108 • Ophthalmology | $1,379 | $6,177 | $18,765 |
| Retinal photocoagulation treatment CPT 67210 • Ophthalmology | $681 | $1,301 | $2,723 |
| Retinal treatment extensive photocoagulation CPT 67228 • Ophthalmology | $295 | $1,226 | $2,723 |
| Strabismus surgery one horizontal muscle CPT 67311 • Ophthalmology | $425 | $2,612 | $10,502 |
| Excision chalazion single CPT 67800 • Ophthalmology | $95 | $291 | $896 |
| Blepharoptosis repair levator resection CPT 67901 • Ophthalmology | $493 | $3,068 | $10,502 |
| Lacrimal punctum closure by plug CPT 68761 • Ophthalmology | $108 | $307 | $896 |
| Eye exam new patient intermediate CPT 92002 • Ophthalmology | $38 | $78 | $111 |
| Eye exam new patient comprehensive CPT 92004 • Ophthalmology | $72 | $166 | $306 |