| Psychotherapy 60 minutes CPT 90837 • Mental Health | $170 | $170 | $170 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $136 | $136 | $136 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $186 | $186 | $186 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $91 | $91 | $91 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $125 | $125 | $125 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $131 | $131 | $131 |
| Group psychotherapy CPT 90853 • Mental Health | $35 | $35 | $35 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $6 | $6 | $6 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $77 | $77 | $77 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $168 | $168 | $168 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $167 | $167 | $167 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $70 | $70 | $70 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $70 | $70 | $70 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $62 | $62 | $62 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $100 | $100 | $100 |
| EMG needle each extremity complete CPT 95886 • Neurology | $118 | $118 | $118 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $46 | $46 | $46 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $138 | $138 | $138 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $97 | $97 | $97 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $129 | $129 | $129 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $124 | $124 | $124 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $82 | $82 | $82 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $93 | $93 | $93 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $191 | $191 | $191 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $207 | $207 | $207 |
| Office visit established patient minimal CPT 99211 • Office Visits | $26 | $26 | $26 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $64 | $64 | $64 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $75 | $75 | $75 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $147 | $147 | $147 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $206 | $206 | $206 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $94 | $94 | $94 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $149 | $149 | $149 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $198 | $198 | $198 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $56 | $56 | $56 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $90 | $90 | $90 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $135 | $135 | $135 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $92 | $92 | $92 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $131 | $131 | $131 |
| Consultation office low complexity CPT 99243 • Office Visits | $129 | $129 | $129 |
| Consultation office high complexity CPT 99245 • Office Visits | $241 | $241 | $241 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $677 | $677 | $677 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $44 | $44 | $44 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,442 | $1,442 | $1,442 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $300 | $300 | $300 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,336 | $1,336 | $1,336 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $618 | $618 | $618 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $365 | $365 | $365 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $910 | $910 | $910 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $664 | $664 | $664 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $138 | $138 | $138 |