| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $60 | $60 | $60 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $379 | $406 | $433 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $67 | $67 | $67 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $175 | $175 | $175 |
| EMG needle each extremity complete CPT 95886 • Neurology | $48 | $48 | $48 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $98 | $98 | $98 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $71 | $71 | $71 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $64 | $64 | $64 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $113 | $113 | $113 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $113 | $113 | $113 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $72 | $74 | $77 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $44 | $72 | $95 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $124 | $138 | $155 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $124 | $156 | $213 |
| Office visit established patient minimal CPT 99211 • Office Visits | $10 | $14 | $23 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $27 | $42 | $57 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $44 | $48 | $53 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $44 | $65 | $82 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $44 | $120 | $168 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $65 | $85 | $105 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $121 | $132 | $143 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $210 | $229 | $248 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $41 | $42 | $43 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $75 | $93 | $111 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $108 | $126 | $144 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $75 | $75 | $75 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $103 | $107 | $111 |
| Consultation office low complexity CPT 99243 • Office Visits | $101 | $101 | $101 |
| Consultation office high complexity CPT 99245 • Office Visits | $200 | $200 | $200 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $616 | $687 | $758 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $42 | $42 | $42 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,331 | $1,331 | $1,331 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $234 | $239 | $245 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,227 | $1,227 | $1,227 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $563 | $563 | $563 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $265 | $280 | $296 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $663 | $753 | $843 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $355 | $485 | $614 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $114 | $142 | $171 |
| Retinal detachment repair with vitrectomy CPT 67108 • Ophthalmology | $1,192 | $1,270 | $1,348 |
| Retinal photocoagulation treatment CPT 67210 • Ophthalmology | $515 | $548 | $580 |
| Retinal treatment extensive photocoagulation CPT 67228 • Ophthalmology | $344 | $350 | $357 |
| Strabismus surgery one horizontal muscle CPT 67311 • Ophthalmology | $670 | $670 | $670 |
| Excision chalazion single CPT 67800 • Ophthalmology | $116 | $118 | $121 |
| Blepharoptosis repair levator resection CPT 67901 • Ophthalmology | $872 | $872 | $872 |
| Lacrimal punctum closure by plug CPT 68761 • Ophthalmology | $166 | $184 | $201 |
| Eye exam new patient intermediate CPT 92002 • Ophthalmology | $49 | $49 | $49 |
| Eye exam new patient comprehensive CPT 92004 • Ophthalmology | $102 | $124 | $147 |
| Eye exam established patient intermediate CPT 92012 • Ophthalmology | $88 | $89 | $90 |
| Eye exam established patient comprehensive CPT 92014 • Ophthalmology | $124 | $126 | $129 |