| Psychotherapy 45 minutes CPT 90834 • Mental Health | $109 | $177 | $224 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $115 | $175 | $218 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $100 | $251 | $335 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $144 | $229 | $286 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $176 | $274 | $349 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $85 | $134 | $167 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $133 | $194 | $246 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $146 | $205 | $255 |
| Group psychotherapy CPT 90853 • Mental Health | $34 | $59 | $69 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $7 | $10 | $12 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $57 | $248 | $407 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $108 | $263 | $341 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $189 | $282 | $346 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $379 | $645 | $841 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $80 | $699 | $997 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $71 | $192 | $281 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $114 | $178 | $211 |
| EMG needle each extremity complete CPT 95886 • Neurology | $49 | $118 | $228 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $74 | $144 | $225 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $93 | $117 | $123 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $111 | $179 | $342 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $103 | $277 | $450 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $148 | $328 | $457 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $60 | $130 | $165 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $109 | $209 | $255 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $132 | $309 | $381 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $237 | $381 | $505 |
| Office visit established patient minimal CPT 99211 • Office Visits | $12 | $41 | $52 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $51 | $96 | $128 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $81 | $149 | $207 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $125 | $221 | $292 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $176 | $312 | $412 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $118 | $192 | $228 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $161 | $260 | $307 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $237 | $381 | $451 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $47 | $74 | $88 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $86 | $137 | $162 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $123 | $197 | $233 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $84 | $138 | $163 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $124 | $202 | $238 |
| Consultation office low complexity CPT 99243 • Office Visits | $0 | $200 | $273 |
| Consultation office high complexity CPT 99245 • Office Visits | $0 | $373 | $499 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $563 | $1,192 | $1,536 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $76 | $94 | $111 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,788 | $2,561 | $2,848 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $291 | $470 | $599 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $218 | $1,950 | $2,634 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $966 | $1,137 | $1,228 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $212 | $565 | $740 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $1,200 | $1,635 | $1,803 |