| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $80 | $80 | $80 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $42 | $42 | $42 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $126 | $126 | $126 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $128 | $128 | $128 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $56 | $56 | $56 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $87 | $87 | $87 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $132 | $132 | $132 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $176 | $176 | $176 |
| Office visit established patient minimal CPT 99211 • Office Visits | $18 | $18 | $18 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $23 | $23 | $23 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $43 | $43 | $43 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $101 | $101 | $101 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $94 | $94 | $94 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $55 | $55 | $55 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $87 | $87 | $87 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $116 | $116 | $116 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $33 | $33 | $33 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $52 | $52 | $52 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $80 | $80 | $80 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $56 | $56 | $56 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $79 | $79 | $79 |
| Consultation office low complexity CPT 99243 • Office Visits | $65 | $65 | $65 |
| Consultation office high complexity CPT 99245 • Office Visits | $157 | $157 | $157 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $434 | $434 | $434 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $26 | $26 | $26 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $680 | $680 | $680 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $169 | $169 | $169 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $644 | $644 | $644 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $306 | $306 | $306 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $206 | $206 | $206 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $433 | $433 | $433 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $318 | $318 | $318 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $78 | $78 | $78 |
| Retinal detachment repair with vitrectomy CPT 67108 • Ophthalmology | $681 | $681 | $681 |
| Retinal photocoagulation treatment CPT 67210 • Ophthalmology | $294 | $294 | $294 |
| Retinal treatment extensive photocoagulation CPT 67228 • Ophthalmology | $234 | $234 | $234 |
| Strabismus surgery one horizontal muscle CPT 67311 • Ophthalmology | $269 | $269 | $269 |
| Excision chalazion single CPT 67800 • Ophthalmology | $90 | $90 | $90 |
| Blepharoptosis repair levator resection CPT 67901 • Ophthalmology | $345 | $345 | $345 |
| Lacrimal punctum closure by plug CPT 68761 • Ophthalmology | $99 | $99 | $99 |
| Eye exam new patient intermediate CPT 92002 • Ophthalmology | $58 | $58 | $58 |
| Eye exam new patient comprehensive CPT 92004 • Ophthalmology | $102 | $102 | $102 |
| Eye exam established patient intermediate CPT 92012 • Ophthalmology | $28 | $28 | $28 |
| Eye exam established patient comprehensive CPT 92014 • Ophthalmology | $42 | $42 | $42 |
| Visual field examination CPT 92083 • Ophthalmology | $18 | $18 | $18 |
| Retinal imaging OCT posterior segment CPT 92134 • Ophthalmology | $22 | $22 | $22 |
| Ophthalmic biometry IOL power calculation CPT 92136 • Ophthalmology | $12 | $12 | $12 |
| Fundus photography CPT 92250 • Ophthalmology | $14 | $14 | $14 |
| Arthrocentesis aspiration small joint CPT 20600 • Orthopedics | $38 | $38 | $38 |
| Arthrocentesis aspiration intermediate joint CPT 20605 • Orthopedics | $22 | $22 | $22 |