| Psychotherapy 60 minutes CPT 90837 • Mental Health | $110 | $147 | $184 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $168 | $168 | $168 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $253 | $253 | $253 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $131 | $131 | $131 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $134 | $134 | $134 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $160 | $160 | $160 |
| Group psychotherapy CPT 90853 • Mental Health | $23 | $34 | $45 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $6 | $7 | $7 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $216 | $216 | $216 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $150 | $159 | $177 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $169 | $171 | $174 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $62 | $234 | $473 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $215 | $391 | $567 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $75 | $75 | $75 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $39 | $39 | $39 |
| EMG needle each extremity complete CPT 95886 • Neurology | $60 | $94 | $128 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $64 | $64 | $64 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $59 | $95 | $150 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $71 | $82 | $92 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $119 | $177 | $235 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $174 | $277 | $379 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $88 | $89 | $90 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $130 | $135 | $139 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $108 | $127 | $145 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $141 | $183 | $234 |
| Office visit established patient minimal CPT 99211 • Office Visits | $11 | $12 | $12 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $44 | $48 | $52 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $48 | $81 | $113 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $78 | $89 | $111 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $129 | $176 | $224 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $92 | $108 | $123 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $153 | $160 | $166 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $200 | $219 | $245 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $46 | $47 | $47 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $76 | $82 | $88 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $108 | $117 | $126 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $88 | $92 | $96 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $79 | $114 | $131 |
| Consultation office low complexity CPT 99243 • Office Visits | $127 | $127 | $127 |
| Consultation office high complexity CPT 99245 • Office Visits | $250 | $250 | $250 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $797 | $797 | $797 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $88 | $88 | $88 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,439 | $1,439 | $1,439 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $433 | $433 | $433 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,298 | $1,298 | $1,298 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $696 | $696 | $696 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $446 | $446 | $446 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $1,251 | $1,251 | $1,251 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $944 | $944 | $944 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $215 | $215 | $215 |