| EMG needle each extremity complete CPT 95886 • Neurology | $97 | $97 | $97 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $18 | $53 | $89 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $111 | $111 | $112 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $78 | $106 | $134 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $71 | $71 | $71 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $285 | $285 | $285 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $71 | $89 | $107 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $158 | $158 | $158 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $164 | $180 | $196 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $246 | $249 | $252 |
| Office visit established patient minimal CPT 99211 • Office Visits | $30 | $32 | $34 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $55 | $59 | $63 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $30 | $67 | $103 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $30 | $95 | $160 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $212 | $212 | $212 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $30 | $90 | $149 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $209 | $209 | $209 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $30 | $168 | $305 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $62 | $62 | $62 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $30 | $71 | $112 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $30 | $95 | $160 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $30 | $72 | $115 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $166 | $166 | $166 |
| Consultation office low complexity CPT 99243 • Office Visits | $30 | $94 | $159 |
| Consultation office high complexity CPT 99245 • Office Visits | $254 | $254 | $255 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $30 | $30 | $30 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $30 | $30 | $30 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,130 | $1,130 | $1,130 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $30 | $30 | $30 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $30 | $30 | $30 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $482 | $482 | $483 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $715 | $715 | $715 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $30 | $276 | $521 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $30 | $30 | $30 |
| Retinal detachment repair with vitrectomy CPT 67108 • Ophthalmology | $30 | $30 | $30 |
| Retinal photocoagulation treatment CPT 67210 • Ophthalmology | $30 | $30 | $30 |
| Retinal treatment extensive photocoagulation CPT 67228 • Ophthalmology | $30 | $30 | $30 |
| Strabismus surgery one horizontal muscle CPT 67311 • Ophthalmology | $462 | $462 | $462 |
| Excision chalazion single CPT 67800 • Ophthalmology | $49 | $49 | $49 |
| Blepharoptosis repair levator resection CPT 67901 • Ophthalmology | $772 | $772 | $772 |
| Eye exam new patient intermediate CPT 92002 • Ophthalmology | $83 | $83 | $83 |
| Eye exam established patient intermediate CPT 92012 • Ophthalmology | $106 | $106 | $106 |
| Eye exam established patient comprehensive CPT 92014 • Ophthalmology | $122 | $122 | $122 |
| Visual field examination CPT 92083 • Ophthalmology | $34 | $34 | $34 |
| Retinal imaging OCT posterior segment CPT 92134 • Ophthalmology | $14 | $27 | $39 |
| Ophthalmic biometry IOL power calculation CPT 92136 • Ophthalmology | $30 | $39 | $48 |
| Fundus photography CPT 92250 • Ophthalmology | $35 | $35 | $36 |
| Arthrocentesis aspiration small joint CPT 20600 • Orthopedics | $86 | $86 | $86 |
| Arthrocentesis aspiration intermediate joint CPT 20605 • Orthopedics | $4 | $28 | $53 |
| Arthrocentesis aspiration major joint CPT 20610 • Orthopedics | $80 | $98 | $115 |