| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $646 | $646 | $646 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $775 | $775 | $775 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $287 | $287 | $287 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $390 | $390 | $390 |
| EMG needle each extremity complete CPT 95886 • Neurology | $158 | $158 | $158 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $165 | $165 | $165 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $187 | $187 | $187 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $249 | $249 | $249 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $328 | $328 | $328 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $530 | $530 | $530 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $113 | $113 | $113 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $174 | $174 | $174 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $261 | $261 | $261 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $333 | $333 | $333 |
| Office visit established patient minimal CPT 99211 • Office Visits | $35 | $35 | $35 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $87 | $87 | $87 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $142 | $142 | $142 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $202 | $202 | $202 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $230 | $230 | $230 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $157 | $157 | $157 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $211 | $211 | $211 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $311 | $311 | $311 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $30 | $30 | $30 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $30 | $30 | $30 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $30 | $30 | $30 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $112 | $112 | $112 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $165 | $165 | $165 |
| Consultation office low complexity CPT 99243 • Office Visits | $187 | $187 | $187 |
| Consultation office high complexity CPT 99245 • Office Visits | $343 | $343 | $343 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $962 | $962 | $962 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $61 | $61 | $61 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,817 | $1,817 | $1,817 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $383 | $383 | $383 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $466 | $466 | $466 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $1,152 | $1,152 | $1,152 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $840 | $840 | $840 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $176 | $176 | $176 |
| Retinal detachment repair with vitrectomy CPT 67108 • Ophthalmology | $1,840 | $1,840 | $1,840 |
| Retinal photocoagulation treatment CPT 67210 • Ophthalmology | $798 | $798 | $798 |
| Retinal treatment extensive photocoagulation CPT 67228 • Ophthalmology | $528 | $528 | $528 |
| Strabismus surgery one horizontal muscle CPT 67311 • Ophthalmology | $922 | $922 | $922 |
| Excision chalazion single CPT 67800 • Ophthalmology | $199 | $199 | $199 |
| Lacrimal punctum closure by plug CPT 68761 • Ophthalmology | $232 | $232 | $232 |
| Eye exam new patient intermediate CPT 92002 • Ophthalmology | $133 | $133 | $133 |
| Eye exam new patient comprehensive CPT 92004 • Ophthalmology | $233 | $233 | $233 |
| Eye exam established patient intermediate CPT 92012 • Ophthalmology | $139 | $139 | $139 |
| Eye exam established patient comprehensive CPT 92014 • Ophthalmology | $196 | $196 | $196 |
| Visual field examination CPT 92083 • Ophthalmology | $97 | $97 | $97 |
| Retinal imaging OCT posterior segment CPT 92134 • Ophthalmology | $63 | $63 | $63 |
| Ophthalmic biometry IOL power calculation CPT 92136 • Ophthalmology | $84 | $84 | $84 |