| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $127 | $135 | $142 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $48 | $61 | $73 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $98 | $105 | $113 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $102 | $128 | $154 |
| Group psychotherapy CPT 90853 • Mental Health | $17 | $21 | $25 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $5 | $7 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $77 | $102 | $145 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $114 | $146 | $183 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $67 | $118 | $169 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $76 | $185 | $270 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $76 | $169 | $263 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $45 | $57 | $69 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $32 | $45 | $58 |
| EMG needle each extremity complete CPT 95886 • Neurology | $49 | $81 | $125 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $90 | $114 | $139 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $65 | $70 | $75 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $112 | $123 | $134 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $64 | $139 | $257 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $285 | $371 | $445 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $33 | $69 | $100 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $102 | $121 | $156 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $30 | $96 | $158 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $160 | $212 | $287 |
| Office visit established patient minimal CPT 99211 • Office Visits | $16 | $21 | $30 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $18 | $35 | $46 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $71 | $121 | $215 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $14 | $93 | $181 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $140 | $180 | $257 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $57 | $79 | $100 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $142 | $157 | $171 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $156 | $193 | $225 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $14 | $35 | $60 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $56 | $87 | $104 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $108 | $128 | $145 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $6 | $59 | $101 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $83 | $109 | $149 |
| Consultation office low complexity CPT 99243 • Office Visits | $75 | $87 | $99 |
| Consultation office high complexity CPT 99245 • Office Visits | $173 | $177 | $180 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $451 | $472 | $494 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $26 | $35 | $43 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,089 | $1,274 | $1,458 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $239 | $281 | $322 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $786 | $864 | $943 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $362 | $570 | $777 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $204 | $215 | $226 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $358 | $566 | $775 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $78 | $520 | $962 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $16 | $57 | $98 |
| Retinal detachment repair with vitrectomy CPT 67108 • Ophthalmology | $30 | $1,025 | $2,020 |
| Retinal photocoagulation treatment CPT 67210 • Ophthalmology | $248 | $368 | $488 |