| Psychotherapy 45 minutes CPT 90834 • Mental Health | $95 | $151 | $253 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $103 | $157 | $250 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $137 | $216 | $372 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $151 | $202 | $298 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $126 | $242 | $358 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $60 | $119 | $178 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $99 | $162 | $274 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $112 | $175 | $286 |
| Group psychotherapy CPT 90853 • Mental Health | $45 | $63 | $76 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $1 | $7 | $13 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $28 | $172 | $271 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $14 | $206 | $433 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $27 | $223 | $431 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $100 | $409 | $894 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $74 | $593 | $1,062 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $107 | $138 | $171 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $72 | $148 | $226 |
| EMG needle each extremity complete CPT 95886 • Neurology | $16 | $84 | $127 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $46 | $100 | $147 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $104 | $121 | $134 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $69 | $135 | $250 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $76 | $228 | $332 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $162 | $407 | $801 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $78 | $117 | $177 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $29 | $137 | $203 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $92 | $204 | $328 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $187 | $322 | $539 |
| Office visit established patient minimal CPT 99211 • Office Visits | $7 | $32 | $47 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $9 | $56 | $74 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $6 | $93 | $136 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $42 | $135 | $262 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $81 | $228 | $368 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $42 | $137 | $183 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $42 | $174 | $288 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $151 | $265 | $385 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $49 | $85 | $116 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $42 | $114 | $175 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $39 | $150 | $264 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $27 | $104 | $179 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $40 | $149 | $253 |
| Consultation office low complexity CPT 99243 • Office Visits | $91 | $173 | $251 |
| Consultation office high complexity CPT 99245 • Office Visits | $42 | $258 | $402 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $46 | $1,055 | $1,577 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $13 | $68 | $123 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,053 | $2,268 | $3,730 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $201 | $517 | $778 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $42 | $1,274 | $3,454 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $114 | $855 | $1,595 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $35 | $510 | $750 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $659 | $1,321 | $2,356 |