| Psychotherapy 45 minutes CPT 90834 • Mental Health | $83 | $121 | $183 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $62 | $113 | $158 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $74 | $145 | $241 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $75 | $169 | $278 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $144 | $195 | $269 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $60 | $102 | $147 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $65 | $136 | $217 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $68 | $146 | $264 |
| Group psychotherapy CPT 90853 • Mental Health | $38 | $46 | $52 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $8 | $13 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $70 | $520 | $955 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $92 | $392 | $955 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $80 | $492 | $955 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $80 | $331 | $556 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $80 | $389 | $673 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $105 | $145 | $225 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $154 | $283 | $411 |
| EMG needle each extremity complete CPT 95886 • Neurology | $93 | $106 | $129 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $86 | $102 | $134 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $130 | $155 | $164 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $129 | $175 | $200 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $168 | $200 | $259 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $275 | $310 | $412 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $61 | $96 | $144 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $50 | $108 | $201 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $50 | $196 | $263 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $30 | $197 | $403 |
| Office visit established patient minimal CPT 99211 • Office Visits | $11 | $25 | $39 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $35 | $49 | $72 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $49 | $73 | $101 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $50 | $126 | $203 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $50 | $130 | $272 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $78 | $139 | $191 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $110 | $160 | $258 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $153 | $223 | $382 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $36 | $67 | $87 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $60 | $95 | $143 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $78 | $129 | $205 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $68 | $96 | $138 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $97 | $127 | $202 |
| Consultation office low complexity CPT 99243 • Office Visits | $116 | $160 | $230 |
| Consultation office high complexity CPT 99245 • Office Visits | $225 | $286 | $421 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $955 | $1,142 | $1,518 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $79 | $744 | $985 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $955 | $1,722 | $2,434 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $152 | $500 | $955 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,180 | $1,931 | $3,954 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $902 | $1,246 | $2,076 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $210 | $508 | $955 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $955 | $1,301 | $1,497 |