| Psychotherapy 60 minutes CPT 90837 • Mental Health | $76 | $170 | $324 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $240 | $252 | $278 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $165 | $223 | $339 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $71 | $118 | $162 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $112 | $201 | $263 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $130 | $199 | $271 |
| Group psychotherapy CPT 90853 • Mental Health | $41 | $60 | $71 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $5 | $8 | $13 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $41 | $198 | $511 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $41 | $173 | $436 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $108 | $180 | $390 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $145 | $272 | $320 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $145 | $287 | $358 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $90 | $113 | $165 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $126 | $205 | $411 |
| EMG needle each extremity complete CPT 95886 • Neurology | $95 | $99 | $107 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $102 | $168 | $233 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $126 | $167 | $287 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $134 | $195 | $345 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $176 | $210 | $267 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $277 | $305 | $326 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $41 | $70 | $144 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $38 | $96 | $210 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $41 | $126 | $258 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $41 | $162 | $403 |
| Office visit established patient minimal CPT 99211 • Office Visits | $25 | $32 | $41 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $41 | $52 | $84 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $41 | $75 | $142 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $41 | $83 | $210 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $41 | $121 | $281 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $41 | $81 | $200 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $41 | $118 | $272 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $29 | $128 | $401 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $41 | $53 | $78 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $41 | $84 | $143 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $41 | $82 | $205 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $41 | $66 | $143 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $91 | $132 | $211 |
| Consultation office low complexity CPT 99243 • Office Visits | $41 | $98 | $194 |
| Consultation office high complexity CPT 99245 • Office Visits | $41 | $239 | $445 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $41 | $533 | $1,518 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $56 | $113 | $226 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $942 | $2,396 | $3,851 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $41 | $479 | $1,118 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $41 | $1,019 | $3,954 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $483 | $1,279 | $2,076 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $41 | $288 | $783 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $41 | $914 | $2,661 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $41 | $719 | $2,135 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $38 | $132 | $339 |