| Psychotherapy 60 minutes CPT 90837 • Mental Health | $114 | $170 | $272 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $92 | $108 | $130 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $118 | $140 | $158 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $46 | $57 | $68 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $78 | $89 | $111 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $76 | $89 | $114 |
| Group psychotherapy CPT 90853 • Mental Health | $21 | $23 | $27 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $3 | $5 | $7 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $153 | $153 | $153 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $129 | $129 | $129 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $121 | $121 | $121 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $63 | $63 | $63 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $379 | $410 | $472 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $131 | $131 | $131 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $188 | $188 | $188 |
| EMG needle each extremity complete CPT 95886 • Neurology | $80 | $93 | $106 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $105 | $105 | $105 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $59 | $77 | $94 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $159 | $159 | $159 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $148 | $179 | $209 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $124 | $124 | $124 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $53 | $81 | $104 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $44 | $106 | $160 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $44 | $131 | $241 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $131 | $176 | $226 |
| Office visit established patient minimal CPT 99211 • Office Visits | $23 | $24 | $25 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $44 | $56 | $84 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $44 | $73 | $130 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $44 | $113 | $183 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $44 | $106 | $168 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $71 | $86 | $111 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $96 | $122 | $150 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $182 | $217 | $248 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $39 | $41 | $43 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $58 | $83 | $111 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $103 | $120 | $144 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $75 | $77 | $80 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $103 | $107 | $117 |
| Consultation office low complexity CPT 99243 • Office Visits | $135 | $135 | $135 |
| Consultation office high complexity CPT 99245 • Office Visits | $210 | $210 | $210 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $673 | $730 | $758 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $50 | $50 | $50 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,291 | $1,291 | $1,291 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $245 | $294 | $368 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,195 | $1,195 | $1,195 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $550 | $550 | $550 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $296 | $307 | $328 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $663 | $715 | $819 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $355 | $486 | $597 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $103 | $127 | $171 |