| Psychotherapy 60 minutes CPT 90837 • Mental Health | $99 | $126 | $139 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $105 | $124 | $152 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $120 | $146 | $172 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $56 | $72 | $89 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $82 | $107 | $134 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $98 | $113 | $150 |
| Group psychotherapy CPT 90853 • Mental Health | $29 | $29 | $29 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $3 | $4 | $5 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $100 | $100 | $100 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $220 | $220 | $220 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $157 | $157 | $157 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $69 | $98 | $127 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $167 | $167 | $167 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $46 | $46 | $46 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $104 | $104 | $104 |
| EMG needle each extremity complete CPT 95886 • Neurology | $49 | $77 | $104 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $96 | $96 | $96 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $51 | $91 | $131 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $143 | $146 | $150 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $108 | $143 | $177 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $116 | $217 | $318 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $40 | $59 | $86 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $30 | $82 | $160 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $30 | $123 | $189 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $160 | $210 | $273 |
| Office visit established patient minimal CPT 99211 • Office Visits | $18 | $24 | $30 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $30 | $40 | $65 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $30 | $50 | $110 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $30 | $63 | $123 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $30 | $98 | $185 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $76 | $93 | $126 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $110 | $152 | $199 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $160 | $184 | $230 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $33 | $39 | $43 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $59 | $79 | $105 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $84 | $93 | $103 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $60 | $85 | $119 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $87 | $114 | $149 |
| Consultation office low complexity CPT 99243 • Office Visits | $111 | $111 | $111 |
| Consultation office high complexity CPT 99245 • Office Visits | $202 | $202 | $202 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $561 | $561 | $561 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $73 | $73 | $73 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,271 | $1,271 | $1,271 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $233 | $258 | $308 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,189 | $1,189 | $1,189 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $631 | $631 | $631 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $460 | $460 | $460 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $1,094 | $1,094 | $1,094 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $323 | $476 | $782 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $103 | $145 | $228 |