| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $144 | $179 | $207 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $124 | $137 | $150 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $66 | $69 | $72 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $93 | $131 | $150 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $80 | $127 | $150 |
| Group psychotherapy CPT 90853 • Mental Health | $26 | $42 | $58 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $4 | $5 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $123 | $199 | $274 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $30 | $139 | $247 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $128 | $132 | $134 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $53 | $243 | $367 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $429 | $603 | $778 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $98 | $107 | $111 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $32 | $87 | $161 |
| EMG needle each extremity complete CPT 95886 • Neurology | $91 | $94 | $97 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $18 | $52 | $89 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $64 | $121 | $187 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $55 | $109 | $138 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $175 | $185 | $205 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $172 | $247 | $285 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $20 | $77 | $147 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $85 | $100 | $109 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $123 | $153 | $169 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $158 | $218 | $345 |
| Office visit established patient minimal CPT 99211 • Office Visits | $21 | $29 | $43 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $43 | $53 | $57 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $30 | $65 | $88 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $30 | $101 | $202 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $136 | $156 | $184 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $30 | $118 | $197 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $96 | $129 | $170 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $30 | $135 | $198 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $45 | $84 | $129 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $30 | $91 | $142 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $30 | $93 | $129 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $30 | $72 | $129 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $82 | $120 | $165 |
| Consultation office low complexity CPT 99243 • Office Visits | $30 | $97 | $170 |
| Consultation office high complexity CPT 99245 • Office Visits | $30 | $166 | $254 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $585 | $593 | $601 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $37 | $71 | $105 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,107 | $1,107 | $1,107 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $233 | $235 | $237 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $30 | $702 | $1,047 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $478 | $481 | $483 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $229 | $229 | $229 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $30 | $371 | $712 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $30 | $288 | $510 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $30 | $70 | $103 |
| Retinal detachment repair with vitrectomy CPT 67108 • Ophthalmology | $30 | $769 | $1,141 |