| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $112 | $112 | $112 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $73 | $73 | $73 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $262 | $262 | $262 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $53 | $57 | $61 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $30 | $67 | $103 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $30 | $154 | $277 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $30 | $99 | $168 |
| Office visit established patient minimal CPT 99211 • Office Visits | $20 | $20 | $20 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $30 | $51 | $73 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $30 | $72 | $114 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $30 | $75 | $119 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $30 | $166 | $301 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $198 | $198 | $198 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $264 | $264 | $264 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $75 | $75 | $75 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $120 | $120 | $120 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $144 | $144 | $144 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $117 | $117 | $117 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $143 | $143 | $143 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $496 | $496 | $496 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $109 | $109 | $109 |
| Retinal photocoagulation treatment CPT 67210 • Ophthalmology | $492 | $492 | $492 |
| Retinal treatment extensive photocoagulation CPT 67228 • Ophthalmology | $324 | $324 | $324 |
| Lacrimal punctum closure by plug CPT 68761 • Ophthalmology | $131 | $131 | $131 |
| Eye exam established patient comprehensive CPT 92014 • Ophthalmology | $115 | $115 | $115 |
| Retinal imaging OCT posterior segment CPT 92134 • Ophthalmology | $26 | $26 | $26 |
| Ophthalmic biometry IOL power calculation CPT 92136 • Ophthalmology | $43 | $43 | $43 |
| Fundus photography CPT 92250 • Ophthalmology | $34 | $34 | $34 |
| Arthrocentesis aspiration major joint CPT 20610 • Orthopedics | $30 | $47 | $65 |
| Carpal tunnel release CPT 64721 • Orthopedics | $535 | $535 | $535 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $127 | $127 | $127 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $260 | $260 | $260 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $257 | $257 | $257 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $250 | $250 | $250 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $111 | $111 | $111 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $269 | $269 | $269 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $136 | $136 | $136 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $123 | $123 | $123 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $657 | $657 | $657 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $236 | $236 | $236 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $33 | $33 | $33 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $12 | $12 | $12 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $8 | $8 | $8 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $20 | $20 | $20 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $25 | $25 | $25 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $19 | $19 | $19 |
| Physical therapy evaluation low complexity CPT 97161 • Physical Therapy | $76 | $76 | $76 |
| Physical therapy evaluation moderate complexity CPT 97162 • Physical Therapy | $75 | $75 | $75 |
| Therapeutic activities each 15 minutes CPT 97530 • Physical Therapy | $27 | $27 | $27 |
| Self-care/home management training each 15 min CPT 97535 • Physical Therapy | $22 | $22 | $22 |