| Psychotherapy 30 minutes CPT 90832 • Mental Health | $69 | $86 | $102 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $71 | $92 | $113 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $78 | $110 | $143 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $76 | $102 | $127 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $123 | $163 | $203 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $92 | $125 | $159 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $145 | $145 | $145 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $46 | $46 | $46 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $78 | $78 | $78 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $76 | $76 | $76 |
| Group psychotherapy CPT 90853 • Mental Health | $22 | $22 | $22 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $3 | $4 | $5 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $379 | $379 | $379 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $72 | $75 | $78 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $95 | $98 | $102 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $155 | $168 | $180 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $33 | $82 | $131 |
| Office visit established patient minimal CPT 99211 • Office Visits | $23 | $24 | $24 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $57 | $60 | $63 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $47 | $72 | $97 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $70 | $103 | $137 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $168 | $181 | $194 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $65 | $65 | $65 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $121 | $121 | $121 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $248 | $248 | $248 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $43 | $43 | $43 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $111 | $111 | $111 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $144 | $144 | $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 | $103 | $103 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $758 | $758 | $758 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $245 | $245 | $245 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $296 | $296 | $296 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $663 | $663 | $663 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $355 | $355 | $355 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $171 | $171 | $171 |
| Retinal detachment repair with vitrectomy CPT 67108 • Ophthalmology | $1,192 | $1,192 | $1,192 |
| Retinal photocoagulation treatment CPT 67210 • Ophthalmology | $515 | $515 | $515 |
| Retinal treatment extensive photocoagulation CPT 67228 • Ophthalmology | $357 | $357 | $357 |
| Excision chalazion single CPT 67800 • Ophthalmology | $121 | $121 | $121 |
| Lacrimal punctum closure by plug CPT 68761 • Ophthalmology | $201 | $201 | $201 |
| Eye exam new patient comprehensive CPT 92004 • Ophthalmology | $147 | $147 | $147 |
| Eye exam established patient intermediate CPT 92012 • Ophthalmology | $88 | $88 | $88 |
| Eye exam established patient comprehensive CPT 92014 • Ophthalmology | $124 | $124 | $124 |
| Visual field examination CPT 92083 • Ophthalmology | $62 | $62 | $62 |
| Retinal imaging OCT posterior segment CPT 92134 • Ophthalmology | $26 | $26 | $26 |
| Ophthalmic biometry IOL power calculation CPT 92136 • Ophthalmology | $29 | $29 | $29 |
| Fundus photography CPT 92250 • Ophthalmology | $36 | $36 | $36 |
| Arthrocentesis aspiration major joint CPT 20610 • Orthopedics | $61 | $65 | $69 |
| Cervical spine fusion anterior approach CPT 22551 • Orthopedics | $265 | $265 | $265 |