| Psychotherapy 60 minutes CPT 90837 • Mental Health | $186 | $186 | $186 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $146 | $146 | $146 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $158 | $158 | $158 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $88 | $88 | $88 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $119 | $119 | $119 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $126 | $126 | $126 |
| Group psychotherapy CPT 90853 • Mental Health | $29 | $29 | $29 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $5 | $5 | $5 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $170 | $170 | $170 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $161 | $161 | $161 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $161 | $161 | $161 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $459 | $459 | $459 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $528 | $528 | $528 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $72 | $72 | $72 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $92 | $92 | $92 |
| EMG needle each extremity complete CPT 95886 • Neurology | $60 | $60 | $60 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $107 | $107 | $107 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $54 | $54 | $54 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $93 | $93 | $93 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $207 | $207 | $207 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $219 | $219 | $219 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $75 | $90 | $102 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $82 | $127 | $152 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $139 | $175 | $216 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $198 | $229 | $275 |
| Office visit established patient minimal CPT 99211 • Office Visits | $25 | $25 | $25 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $36 | $54 | $62 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $28 | $73 | $99 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $94 | $124 | $141 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $158 | $182 | $190 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $90 | $150 | $171 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $143 | $143 | $143 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $190 | $190 | $190 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $54 | $54 | $54 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $86 | $86 | $86 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $130 | $130 | $130 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $89 | $89 | $89 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $125 | $125 | $125 |
| Consultation office low complexity CPT 99243 • Office Visits | $123 | $123 | $123 |
| Consultation office high complexity CPT 99245 • Office Visits | $198 | $198 | $198 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $30 | $471 | $651 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $28 | $68 | $101 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,386 | $1,386 | $1,386 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $288 | $427 | $496 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,285 | $1,285 | $1,285 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $594 | $594 | $594 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $28 | $297 | $585 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $28 | $764 | $1,437 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $30 | $568 | $1,082 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $109 | $115 | $133 |