| Psychotherapy 45 minutes CPT 90834 • Mental Health | $73 | $104 | $134 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $61 | $94 | $135 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $107 | $141 | $157 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $98 | $128 | $188 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $154 | $166 | $178 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $52 | $73 | $86 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $73 | $104 | $145 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $93 | $120 | $130 |
| Group psychotherapy CPT 90853 • Mental Health | $25 | $27 | $28 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $5 | $5 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $47 | $156 | $222 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $112 | $167 | $237 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $112 | $211 | $245 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $56 | $351 | $609 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $45 | $524 | $715 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $63 | $86 | $128 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $31 | $154 | $248 |
| EMG needle each extremity complete CPT 95886 • Neurology | $42 | $119 | $160 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $57 | $67 | $83 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $58 | $97 | $132 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $54 | $136 | $219 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $69 | $227 | $286 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $103 | $233 | $322 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $32 | $85 | $111 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $65 | $122 | $165 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $81 | $150 | $245 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $126 | $223 | $347 |
| Office visit established patient minimal CPT 99211 • Office Visits | $10 | $26 | $41 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $16 | $53 | $83 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $32 | $88 | $133 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $65 | $139 | $201 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $88 | $196 | $265 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $64 | $131 | $156 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $87 | $170 | $203 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $129 | $249 | $287 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $26 | $49 | $58 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $48 | $85 | $107 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $68 | $121 | $154 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $47 | $77 | $104 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $69 | $113 | $152 |
| Consultation office low complexity CPT 99243 • Office Visits | $0 | $111 | $176 |
| Consultation office high complexity CPT 99245 • Office Visits | $0 | $197 | $319 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $412 | $826 | $1,078 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $33 | $55 | $67 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $737 | $1,403 | $2,010 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $215 | $366 | $474 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $845 | $1,431 | $1,869 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $451 | $770 | $1,119 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $291 | $462 | $521 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $769 | $1,106 | $1,272 |