| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $80 | $132 | $199 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $128 | $174 | $245 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $107 | $182 | $263 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $128 | $192 | $255 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $63 | $113 | $151 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $97 | $170 | $245 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $101 | $162 | $254 |
| Group psychotherapy CPT 90853 • Mental Health | $26 | $31 | $40 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $6 | $7 | $8 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $97 | $196 | $350 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $164 | $231 | $304 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $178 | $224 | $294 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $287 | $479 | $690 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $52 | $363 | $747 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $48 | $143 | $284 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $146 | $146 | $146 |
| EMG needle each extremity complete CPT 95886 • Neurology | $44 | $110 | $170 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $48 | $81 | $142 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $86 | $105 | $126 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $49 | $132 | $224 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $115 | $183 | $258 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $130 | $295 | $375 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $84 | $106 | $133 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $102 | $125 | $168 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $146 | $170 | $204 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $234 | $257 | $274 |
| Office visit established patient minimal CPT 99211 • Office Visits | $11 | $26 | $36 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $30 | $43 | $68 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $56 | $94 | $119 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $86 | $125 | $193 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $163 | $190 | $226 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $126 | $167 | $203 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $157 | $182 | $220 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $231 | $261 | $324 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $48 | $59 | $67 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $85 | $110 | $154 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $130 | $160 | $189 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $91 | $114 | $154 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $121 | $154 | $194 |
| Consultation office low complexity CPT 99243 • Office Visits | $110 | $146 | $225 |
| Consultation office high complexity CPT 99245 • Office Visits | $259 | $342 | $451 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $894 | $967 | $1,039 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $64 | $80 | $98 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,474 | $1,757 | $2,139 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $444 | $455 | $466 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,295 | $1,789 | $2,564 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $772 | $1,098 | $1,424 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $369 | $483 | $543 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $727 | $1,180 | $1,825 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $64 | $682 | $1,027 |