| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $196 | $275 | $339 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $194 | $283 | $328 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $96 | $129 | $141 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $94 | $114 | $132 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $97 | $163 | $185 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $124 | $143 | $167 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $173 | $239 | $271 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $163 | $213 | $248 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $199 | $240 | $261 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $66 | $107 | $147 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $138 | $195 | $261 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $172 | $220 | $271 |
| Group psychotherapy CPT 90853 • Mental Health | $33 | $39 | $49 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $5 | $9 | $13 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $251 | $5,130 | $19,682 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $57 | $167 | $245 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $57 | $160 | $238 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $145 | $576 | $791 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $489 | $780 | $925 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $69 | $181 | $218 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $178 | $263 | $292 |
| EMG needle each extremity complete CPT 95886 • Neurology | $100 | $155 | $182 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $168 | $190 | $233 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $120 | $188 | $211 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $84 | $167 | $254 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $257 | $306 | $330 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $375 | $478 | $530 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $69 | $110 | $131 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $144 | $181 | $200 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $30 | $209 | $323 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $30 | $222 | $397 |
| Office visit established patient minimal CPT 99211 • Office Visits | $10 | $33 | $45 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $60 | $89 | $104 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $70 | $132 | $164 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $30 | $125 | $232 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $151 | $268 | $327 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $138 | $158 | $169 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $181 | $183 | $187 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $43 | $201 | $275 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $49 | $69 | $80 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $98 | $106 | $110 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $108 | $147 | $166 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $76 | $105 | $119 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $132 | $161 | $170 |
| Consultation office low complexity CPT 99243 • Office Visits | $132 | $161 | $189 |
| Consultation office high complexity CPT 99245 • Office Visits | $233 | $318 | $346 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $464 | $11,366 | $42,765 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $57 | $78 | $110 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,646 | $2,450 | $4,750 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $57 | $275 | $429 |