| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $128 | $258 | $387 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $52 | $58 | $64 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $39 | $39 | $39 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $93 | $93 | $93 |
| EMG needle each extremity complete CPT 95886 • Neurology | $45 | $66 | $86 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $110 | $110 | $110 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $112 | $124 | $135 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $73 | $82 | $92 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $90 | $90 | $90 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $262 | $307 | $351 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $50 | $55 | $61 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $77 | $90 | $103 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $114 | $196 | $277 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $168 | $176 | $183 |
| Office visit established patient minimal CPT 99211 • Office Visits | $20 | $21 | $22 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $26 | $49 | $73 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $55 | $85 | $114 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $63 | $91 | $119 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $127 | $214 | $301 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $73 | $73 | $73 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $120 | $159 | $198 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $168 | $216 | $264 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $36 | $55 | $75 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $60 | $90 | $120 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $85 | $114 | $144 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $76 | $96 | $117 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $103 | $123 | $143 |
| Consultation office low complexity CPT 99243 • Office Visits | $99 | $99 | $99 |
| Consultation office high complexity CPT 99245 • Office Visits | $196 | $196 | $196 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $665 | $665 | $665 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $73 | $73 | $73 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,203 | $1,203 | $1,203 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $361 | $361 | $361 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,083 | $1,083 | $1,083 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $581 | $581 | $581 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $426 | $426 | $426 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $1,046 | $1,046 | $1,046 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $496 | $642 | $789 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $109 | $170 | $232 |
| Retinal detachment repair with vitrectomy CPT 67108 • Ophthalmology | $1,582 | $1,582 | $1,582 |
| Retinal photocoagulation treatment CPT 67210 • Ophthalmology | $492 | $591 | $690 |
| Retinal treatment extensive photocoagulation CPT 67228 • Ophthalmology | $324 | $640 | $956 |
| Strabismus surgery one horizontal muscle CPT 67311 • Ophthalmology | $566 | $566 | $566 |
| Excision chalazion single CPT 67800 • Ophthalmology | $133 | $133 | $133 |
| Blepharoptosis repair levator resection CPT 67901 • Ophthalmology | $559 | $559 | $559 |
| Lacrimal punctum closure by plug CPT 68761 • Ophthalmology | $119 | $119 | $119 |
| Eye exam new patient intermediate CPT 92002 • Ophthalmology | $75 | $75 | $75 |
| Eye exam new patient comprehensive CPT 92004 • Ophthalmology | $136 | $136 | $136 |
| Eye exam established patient intermediate CPT 92012 • Ophthalmology | $68 | $68 | $68 |
| Eye exam established patient comprehensive CPT 92014 • Ophthalmology | $65 | $90 | $115 |