| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $98 | $138 | $215 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $170 | $195 | $230 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $135 | $184 | $284 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $163 | $182 | $221 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $72 | $81 | $98 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $84 | $115 | $151 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $114 | $128 | $156 |
| Group psychotherapy CPT 90853 • Mental Health | $26 | $31 | $37 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $6 | $8 | $11 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $144 | $157 | $164 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $158 | $236 | $316 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $135 | $194 | $311 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $252 | $341 | $492 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $87 | $210 | $271 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $78 | $87 | $91 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $130 | $159 | $246 |
| EMG needle each extremity complete CPT 95886 • Neurology | $79 | $91 | $97 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $81 | $96 | $104 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $129 | $140 | $171 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $82 | $119 | $155 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $71 | $187 | $269 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $333 | $369 | $440 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $57 | $100 | $173 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $83 | $113 | $172 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $127 | $262 | $400 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $160 | $344 | $529 |
| Office visit established patient minimal CPT 99211 • Office Visits | $16 | $31 | $55 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $32 | $71 | $135 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $53 | $115 | $217 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $73 | $221 | $307 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $98 | $139 | $222 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $78 | $121 | $200 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $107 | $139 | $202 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $158 | $251 | $420 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $32 | $47 | $77 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $58 | $87 | $123 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $83 | $115 | $185 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $58 | $88 | $125 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $85 | $156 | $277 |
| Consultation office low complexity CPT 99243 • Office Visits | $112 | $176 | $274 |
| Consultation office high complexity CPT 99245 • Office Visits | $203 | $300 | $512 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $501 | $756 | $1,265 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $65 | $73 | $89 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,089 | $2,010 | $2,691 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $317 | $368 | $470 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,091 | $1,558 | $2,492 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $582 | $724 | $1,151 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $418 | $576 | $683 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $980 | $1,554 | $1,983 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $704 | $994 | $1,241 |