| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $66 | $99 | $116 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $109 | $144 | $184 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $107 | $126 | $144 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $176 | $176 | $177 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $92 | $94 | $96 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $80 | $133 | $150 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $100 | $137 | $150 |
| Group psychotherapy CPT 90853 • Mental Health | $30 | $55 | $77 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $4 | $5 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $30 | $69 | $147 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $30 | $74 | $162 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $110 | $127 | $134 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $262 | $312 | $367 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $357 | $405 | $429 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $91 | $106 | $111 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $76 | $140 | $161 |
| EMG needle each extremity complete CPT 95886 • Neurology | $46 | $80 | $97 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $89 | $89 | $90 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $111 | $111 | $112 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $75 | $114 | $134 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $175 | $175 | $175 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $285 | $286 | $288 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $69 | $70 | $71 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $100 | $106 | $109 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $139 | $152 | $164 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $161 | $187 | $216 |
| Office visit established patient minimal CPT 99211 • Office Visits | $9 | $25 | $30 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $40 | $51 | $55 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $30 | $62 | $75 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $30 | $90 | $125 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $104 | $152 | $176 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $30 | $116 | $170 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $128 | $130 | $131 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $188 | $196 | $198 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $37 | $86 | $110 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $30 | $79 | $110 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $30 | $81 | $99 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $30 | $79 | $110 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $99 | $112 | $130 |
| Consultation office low complexity CPT 99243 • Office Visits | $30 | $86 | $170 |
| Consultation office high complexity CPT 99245 • Office Visits | $208 | $243 | $255 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $30 | $195 | $524 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $30 | $42 | $65 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,084 | $1,107 | $1,130 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $30 | $155 | $281 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $30 | $301 | $1,115 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $482 | $507 | $582 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $30 | $135 | $240 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $30 | $580 | $996 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $30 | $202 | $718 |