| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $176 | $390 | $725 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $48 | $95 | $184 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $80 | $146 | $285 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $122 | $239 | $426 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $154 | $293 | $562 |
| Office visit established patient minimal CPT 99211 • Office Visits | $10 | $29 | $60 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $37 | $60 | $88 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $56 | $118 | $233 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $61 | $159 | $327 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $114 | $216 | $459 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $74 | $132 | $200 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $112 | $177 | $272 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $147 | $250 | $401 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $37 | $66 | $92 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $61 | $99 | $143 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $86 | $140 | $205 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $74 | $104 | $143 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $94 | $146 | $211 |
| Consultation office low complexity CPT 99243 • Office Visits | $73 | $188 | $286 |
| Consultation office high complexity CPT 99245 • Office Visits | $142 | $343 | $529 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $614 | $1,109 | $1,678 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $54 | $95 | $179 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,052 | $2,227 | $3,851 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $171 | $528 | $1,118 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $169 | $1,922 | $3,954 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $487 | $1,095 | $2,076 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $168 | $546 | $970 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $813 | $1,561 | $2,661 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $640 | $1,207 | $2,135 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $65 | $207 | $334 |
| Retinal detachment repair with vitrectomy CPT 67108 • Ophthalmology | $1,379 | $2,751 | $5,343 |
| Retinal photocoagulation treatment CPT 67210 • Ophthalmology | $566 | $1,003 | $1,660 |
| Retinal treatment extensive photocoagulation CPT 67228 • Ophthalmology | $201 | $1,173 | $3,339 |
| Strabismus surgery one horizontal muscle CPT 67311 • Ophthalmology | $458 | $1,034 | $2,001 |
| Excision chalazion single CPT 67800 • Ophthalmology | $88 | $227 | $420 |
| Blepharoptosis repair levator resection CPT 67901 • Ophthalmology | $493 | $1,341 | $2,496 |
| Lacrimal punctum closure by plug CPT 68761 • Ophthalmology | $100 | $240 | $396 |
| Eye exam new patient intermediate CPT 92002 • Ophthalmology | $38 | $122 | $215 |
| Eye exam new patient comprehensive CPT 92004 • Ophthalmology | $62 | $215 | $378 |
| Eye exam established patient intermediate CPT 92012 • Ophthalmology | $30 | $123 | $226 |
| Eye exam established patient comprehensive CPT 92014 • Ophthalmology | $48 | $182 | $320 |
| Visual field examination CPT 92083 • Ophthalmology | $39 | $73 | $96 |
| Retinal imaging OCT posterior segment CPT 92134 • Ophthalmology | $13 | $46 | $83 |
| Ophthalmic biometry IOL power calculation CPT 92136 • Ophthalmology | $36 | $65 | $79 |
| Fundus photography CPT 92250 • Ophthalmology | $26 | $57 | $94 |
| Arthrocentesis aspiration small joint CPT 20600 • Orthopedics | $19 | $65 | $118 |
| Arthrocentesis aspiration intermediate joint CPT 20605 • Orthopedics | $27 | $69 | $123 |
| Arthrocentesis aspiration major joint CPT 20610 • Orthopedics | $29 | $102 | $193 |
| Cervical spine fusion anterior approach CPT 22551 • Orthopedics | $245 | $2,941 | $5,509 |
| Lumbar spine fusion posterior approach CPT 22612 • Orthopedics | $1,006 | $2,854 | $5,147 |