| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $4 | $5 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $123 | $131 | $146 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $30 | $97 | $131 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $133 | $137 | $149 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $310 | $327 | $367 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $57 | $305 | $429 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $51 | $91 | $111 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $80 | $120 | $161 |
| EMG needle each extremity complete CPT 95886 • Neurology | $97 | $97 | $98 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $52 | $62 | $90 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $46 | $89 | $111 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $55 | $115 | $135 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $104 | $158 | $177 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $285 | $286 | $289 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $47 | $69 | $130 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $30 | $76 | $130 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $30 | $131 | $168 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $30 | $126 | $184 |
| Office visit established patient minimal CPT 99211 • Office Visits | $22 | $45 | $130 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $30 | $60 | $130 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $30 | $69 | $130 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $30 | $83 | $130 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $30 | $93 | $181 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $30 | $44 | $84 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $131 | $131 | $132 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $30 | $109 | $198 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $30 | $37 | $50 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $30 | $43 | $81 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $30 | $87 | $121 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $30 | $43 | $82 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $101 | $112 | $130 |
| Consultation office straightforward CPT 99241 • Office Visits | $130 | $130 | $130 |
| Consultation office low complexity CPT 99243 • Office Visits | $5 | $84 | $170 |
| Consultation office high complexity CPT 99245 • Office Visits | $5 | $180 | $255 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $601 | $603 | $606 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $37 | $39 | $43 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,130 | $1,183 | $1,290 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $237 | $248 | $269 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $30 | $830 | $1,194 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $482 | $500 | $552 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $288 | $308 | $327 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $715 | $748 | $814 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $30 | $382 | $595 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $30 | $93 | $124 |
| Retinal detachment repair with vitrectomy CPT 67108 • Ophthalmology | $30 | $625 | $1,299 |
| Retinal photocoagulation treatment CPT 67210 • Ophthalmology | $30 | $396 | $564 |
| Retinal treatment extensive photocoagulation CPT 67228 • Ophthalmology | $30 | $263 | $372 |
| Strabismus surgery one horizontal muscle CPT 67311 • Ophthalmology | $462 | $474 | $497 |
| Excision chalazion single CPT 67800 • Ophthalmology | $30 | $98 | $142 |
| Blepharoptosis repair levator resection CPT 67901 • Ophthalmology | $771 | $823 | $874 |