| Psychotherapy 60 minutes CPT 90837 • Mental Health | $139 | $189 | $271 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $164 | $164 | $164 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $199 | $199 | $199 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $87 | $87 | $87 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $113 | $122 | $140 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $125 | $138 | $146 |
| Group psychotherapy CPT 90853 • Mental Health | $38 | $38 | $38 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $6 | $6 | $8 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $96 | $167 | $192 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $180 | $180 | $180 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $134 | $164 | $181 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $79 | $282 | $518 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $56 | $380 | $596 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $88 | $88 | $88 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $114 | $114 | $114 |
| EMG needle each extremity complete CPT 95886 • Neurology | $63 | $108 | $141 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $54 | $54 | $54 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $163 | $163 | $163 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $74 | $109 | $201 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $71 | $187 | $257 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $184 | $314 | $432 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $64 | $80 | $97 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $30 | $120 | $157 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $132 | $204 | $237 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $180 | $254 | $316 |
| Office visit established patient minimal CPT 99211 • Office Visits | $13 | $24 | $31 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $61 | $74 | $86 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $30 | $76 | $140 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $125 | $160 | $197 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $196 | $240 | $276 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $110 | $136 | $171 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $128 | $171 | $199 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $168 | $231 | $276 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $30 | $72 | $130 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $69 | $105 | $130 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $97 | $138 | $181 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $30 | $96 | $130 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $110 | $146 | $175 |
| Consultation office low complexity CPT 99243 • Office Visits | $93 | $123 | $145 |
| Consultation office high complexity CPT 99245 • Office Visits | $263 | $263 | $263 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $827 | $827 | $827 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $62 | $62 | $62 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,597 | $1,597 | $1,597 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $332 | $332 | $332 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,473 | $1,473 | $1,473 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $675 | $675 | $675 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $318 | $318 | $318 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $1,011 | $1,011 | $1,011 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $737 | $737 | $737 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $137 | $137 | $137 |