| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $89 | $152 | $216 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $113 | $258 | $403 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $136 | $227 | $318 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $177 | $282 | $387 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $172 | $172 | $172 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $117 | $190 | $263 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $121 | $198 | $275 |
| Group psychotherapy CPT 90853 • Mental Health | $44 | $59 | $73 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $8 | $12 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $354 | $469 | $583 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $118 | $295 | $451 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $363 | $412 | $461 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $152 | $224 | $297 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $348 | $761 | $1,173 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $136 | $136 | $136 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $62 | $136 | $218 |
| EMG needle each extremity complete CPT 95886 • Neurology | $78 | $169 | $261 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $71 | $106 | $142 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $88 | $159 | $300 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $46 | $129 | $213 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $138 | $164 | $189 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $224 | $362 | $501 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $141 | $161 | $182 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $218 | $241 | $263 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $109 | $245 | $325 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $189 | $336 | $429 |
| Office visit established patient minimal CPT 99211 • Office Visits | $17 | $33 | $48 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $105 | $108 | $110 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $176 | $177 | $178 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $88 | $151 | $250 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $350 | $352 | $354 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $163 | $207 | $250 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $256 | $297 | $339 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $185 | $342 | $501 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $97 | $97 | $97 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $156 | $167 | $179 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $234 | $246 | $257 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $159 | $169 | $179 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $98 | $196 | $265 |
| Consultation office low complexity CPT 99243 • Office Visits | $142 | $215 | $281 |
| Consultation office high complexity CPT 99245 • Office Visits | $182 | $383 | $551 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $1,476 | $1,852 | $2,228 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $104 | $178 | $252 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $3,140 | $3,611 | $4,081 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $655 | $793 | $931 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $2,908 | $3,237 | $3,566 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $1,343 | $1,853 | $2,363 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $797 | $941 | $1,084 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $1,983 | $2,360 | $2,736 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $1,448 | $1,823 | $2,198 |