| Psychotherapy 60 minutes CPT 90837 • Mental Health | $99 | $122 | $145 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $133 | $133 | $133 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $204 | $204 | $204 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $105 | $105 | $105 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $100 | $100 | $100 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $125 | $125 | $125 |
| Group psychotherapy CPT 90853 • Mental Health | $37 | $37 | $37 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $5 | $6 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $87 | $87 | $87 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $177 | $177 | $177 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $139 | $139 | $139 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $272 | $272 | $272 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $297 | $297 | $297 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $95 | $95 | $95 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $138 | $138 | $138 |
| EMG needle each extremity complete CPT 95886 • Neurology | $106 | $106 | $106 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $114 | $114 | $114 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $141 | $141 | $141 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $95 | $95 | $95 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $222 | $222 | $222 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $366 | $366 | $366 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $55 | $61 | $66 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $83 | $90 | $95 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $30 | $97 | $173 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $30 | $126 | $225 |
| Office visit established patient minimal CPT 99211 • Office Visits | $10 | $17 | $23 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $28 | $42 | $56 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $30 | $54 | $85 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $30 | $62 | $112 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $119 | $130 | $151 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $71 | $90 | $109 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $100 | $120 | $148 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $135 | $162 | $218 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $43 | $44 | $45 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $55 | $73 | $100 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $90 | $102 | $113 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $75 | $76 | $78 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $106 | $110 | $114 |
| Consultation office low complexity CPT 99243 • Office Visits | $143 | $143 | $143 |
| Consultation office high complexity CPT 99245 • Office Visits | $222 | $222 | $222 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $668 | $668 | $668 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $71 | $71 | $71 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,198 | $1,198 | $1,198 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $233 | $290 | $347 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,213 | $1,213 | $1,213 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $638 | $638 | $638 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $459 | $459 | $459 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $1,099 | $1,099 | $1,099 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $461 | $626 | $790 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $103 | $140 | $176 |