| Group psychotherapy CPT 90853 • Mental Health | $39 | $40 | $42 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $6 | $6 | $7 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $89 | $775 | $2,080 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $148 | $338 | $697 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $122 | $322 | $697 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $144 | $357 | $569 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $163 | $409 | $655 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $79 | $121 | $164 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $92 | $163 | $233 |
| EMG needle each extremity complete CPT 95886 • Neurology | $54 | $97 | $140 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $107 | $119 | $132 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $132 | $148 | $164 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $158 | $177 | $197 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $207 | $232 | $257 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $341 | $380 | $419 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $57 | $71 | $86 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $87 | $110 | $132 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $129 | $164 | $199 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $171 | $217 | $262 |
| Office visit established patient minimal CPT 99211 • Office Visits | $11 | $19 | $27 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $29 | $48 | $67 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $56 | $67 | $77 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $71 | $112 | $153 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $114 | $164 | $215 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $74 | $86 | $98 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $124 | $139 | $155 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $172 | $189 | $206 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $37 | $48 | $59 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $61 | $78 | $94 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $87 | $114 | $141 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $78 | $87 | $96 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $106 | $121 | $136 |
| Consultation office low complexity CPT 99243 • Office Visits | $90 | $112 | $134 |
| Consultation office high complexity CPT 99245 • Office Visits | $178 | $215 | $251 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $614 | $1,724 | $3,882 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $42 | $264 | $697 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,105 | $5,848 | $15,163 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $265 | $897 | $2,080 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,019 | $3,491 | $8,271 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $487 | $3,102 | $8,271 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $323 | $926 | $2,080 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $805 | $3,296 | $8,271 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $587 | $3,166 | $8,271 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $122 | $331 | $697 |
| Retinal detachment repair with vitrectomy CPT 67108 • Ophthalmology | $1,282 | $5,941 | $15,163 |
| Retinal photocoagulation treatment CPT 67210 • Ophthalmology | $557 | $1,106 | $2,080 |
| Retinal treatment extensive photocoagulation CPT 67228 • Ophthalmology | $367 | $1,127 | $2,080 |
| Strabismus surgery one horizontal muscle CPT 67311 • Ophthalmology | $458 | $3,074 | $8,271 |
| Excision chalazion single CPT 67800 • Ophthalmology | $95 | $311 | $697 |
| Blepharoptosis repair levator resection CPT 67901 • Ophthalmology | $493 | $3,207 | $8,271 |