| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $74 | $109 | $164 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $126 | $189 | $297 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $123 | $165 | $313 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $117 | $221 | $544 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $58 | $80 | $100 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $79 | $149 | $342 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $109 | $137 | $191 |
| Group psychotherapy CPT 90853 • Mental Health | $30 | $37 | $49 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $5 | $6 | $7 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $166 | $247 | $348 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $30 | $144 | $261 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $69 | $141 | $256 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $65 | $242 | $367 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $92 | $376 | $604 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $41 | $74 | $116 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $89 | $186 | $468 |
| EMG needle each extremity complete CPT 95886 • Neurology | $75 | $114 | $159 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $41 | $73 | $126 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $66 | $119 | $178 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $91 | $155 | $226 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $121 | $238 | $496 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $215 | $284 | $399 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $71 | $92 | $152 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $86 | $141 | $186 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $146 | $229 | $334 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $160 | $307 | $457 |
| Office visit established patient minimal CPT 99211 • Office Visits | $19 | $30 | $49 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $37 | $65 | $118 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $30 | $86 | $135 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $30 | $150 | $352 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $125 | $218 | $371 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $30 | $109 | $215 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $98 | $141 | $188 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $19 | $208 | $379 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $42 | $53 | $76 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $30 | $96 | $205 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $30 | $119 | $173 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $30 | $84 | $126 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $117 | $147 | $228 |
| Consultation office low complexity CPT 99243 • Office Visits | $30 | $119 | $150 |
| Consultation office high complexity CPT 99245 • Office Visits | $220 | $247 | $324 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $375 | $862 | $1,878 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $50 | $117 | $375 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,069 | $2,679 | $4,908 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $217 | $286 | $375 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $30 | $1,346 | $2,846 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $483 | $1,375 | $2,846 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $56 | $296 | $423 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $471 | $1,552 | $2,846 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $30 | $1,279 | $2,846 |