| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $175 | $175 | $175 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $285 | $285 | $285 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $61 | $87 | $113 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $93 | $98 | $103 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $144 | $202 | $261 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $191 | $203 | $215 |
| Office visit established patient minimal CPT 99211 • Office Visits | $16 | $26 | $35 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $25 | $56 | $87 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $65 | $67 | $69 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $119 | $160 | $202 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $141 | $185 | $230 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $171 | $171 | $171 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $113 | $142 | $171 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $161 | $165 | $168 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $45 | $88 | $130 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $73 | $102 | $130 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $110 | $120 | $130 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $75 | $102 | $130 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $103 | $116 | $130 |
| Consultation office low complexity CPT 99243 • Office Visits | $171 | $171 | $171 |
| Consultation office high complexity CPT 99245 • Office Visits | $343 | $343 | $343 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $689 | $826 | $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 | $233 | $308 | $383 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,047 | $1,047 | $1,047 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $482 | $482 | $482 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $284 | $375 | $466 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $680 | $916 | $1,152 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $411 | $626 | $840 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $109 | $142 | $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 | $486 | $507 | $528 |
| Strabismus surgery one horizontal muscle CPT 67311 • Ophthalmology | $417 | $669 | $922 |
| Excision chalazion single CPT 67800 • Ophthalmology | $199 | $199 | $199 |
| Blepharoptosis repair levator resection CPT 67901 • Ophthalmology | $771 | $771 | $771 |
| Lacrimal punctum closure by plug CPT 68761 • Ophthalmology | $63 | $147 | $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 | $56 | $77 | $97 |
| Retinal imaging OCT posterior segment CPT 92134 • Ophthalmology | $24 | $44 | $63 |
| Ophthalmic biometry IOL power calculation CPT 92136 • Ophthalmology | $26 | $55 | $84 |
| Fundus photography CPT 92250 • Ophthalmology | $33 | $47 | $61 |
| Arthrocentesis aspiration small joint CPT 20600 • Orthopedics | $81 | $81 | $81 |
| Arthrocentesis aspiration intermediate joint CPT 20605 • Orthopedics | $69 | $77 | $84 |
| Arthrocentesis aspiration major joint CPT 20610 • Orthopedics | $61 | $67 | $72 |
| Cervical spine fusion anterior approach CPT 22551 • Orthopedics | $1,463 | $2,060 | $2,656 |