| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $182 | $259 | $343 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $76 | $107 | $144 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $77 | $98 | $133 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $99 | $139 | $190 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $92 | $125 | $169 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $141 | $213 | $357 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $130 | $170 | $225 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $148 | $208 | $293 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $72 | $102 | $140 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $108 | $138 | $182 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $119 | $147 | $190 |
| Group psychotherapy CPT 90853 • Mental Health | $27 | $37 | $51 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $5 | $6 | $8 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $52 | $163 | $250 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $15 | $187 | $370 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $109 | $176 | $246 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $73 | $445 | $642 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $55 | $477 | $747 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $65 | $99 | $187 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $103 | $207 | $480 |
| EMG needle each extremity complete CPT 95886 • Neurology | $52 | $107 | $158 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $46 | $107 | $269 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $56 | $105 | $188 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $55 | $131 | $226 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $104 | $162 | $296 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $149 | $282 | $487 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $40 | $93 | $124 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $67 | $147 | $196 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $109 | $198 | $251 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $148 | $261 | $389 |
| Office visit established patient minimal CPT 99211 • Office Visits | $6 | $27 | $48 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $26 | $65 | $98 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $45 | $95 | $137 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $71 | $153 | $224 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $105 | $223 | $315 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $78 | $113 | $146 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $115 | $172 | $230 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $167 | $262 | $338 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $40 | $53 | $72 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $64 | $95 | $140 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $104 | $157 | $230 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $72 | $100 | $142 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $102 | $149 | $201 |
| Consultation office low complexity CPT 99243 • Office Visits | $52 | $158 | $292 |
| Consultation office high complexity CPT 99245 • Office Visits | $113 | $277 | $531 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $533 | $922 | $1,734 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $36 | $77 | $196 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $939 | $1,607 | $3,376 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $164 | $341 | $697 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $220 | $1,512 | $3,122 |