| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $126 | $213 | $299 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $144 | $323 | $501 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $142 | $249 | $356 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $170 | $325 | $481 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $82 | $148 | $213 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $155 | $241 | $327 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $121 | $231 | $340 |
| Group psychotherapy CPT 90853 • Mental Health | $50 | $65 | $80 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $3 | $9 | $15 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $35 | $238 | $441 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $138 | $265 | $393 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $127 | $289 | $451 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $74 | $132 | $189 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $425 | $942 | $1,459 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $25 | $199 | $374 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $95 | $180 | $264 |
| EMG needle each extremity complete CPT 95886 • Neurology | $47 | $186 | $325 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $97 | $198 | $299 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $25 | $199 | $373 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $30 | $147 | $264 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $103 | $169 | $235 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $146 | $384 | $622 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $24 | $86 | $164 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $81 | $135 | $189 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $125 | $277 | $378 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $203 | $349 | $432 |
| Office visit established patient minimal CPT 99211 • Office Visits | $1 | $21 | $44 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $58 | $93 | $114 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $33 | $75 | $134 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $89 | $169 | $258 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $143 | $286 | $362 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $131 | $202 | $285 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $148 | $277 | $384 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $33 | $332 | $566 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $57 | $93 | $113 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $79 | $154 | $203 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $150 | $238 | $292 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $11 | $133 | $203 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $132 | $231 | $300 |
| Consultation office low complexity CPT 99243 • Office Visits | $18 | $206 | $341 |
| Consultation office high complexity CPT 99245 • Office Visits | $220 | $443 | $624 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $351 | $1,211 | $2,071 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $14 | $71 | $129 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $826 | $2,365 | $3,904 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $297 | $556 | $815 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $845 | $2,230 | $3,615 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $97 | $883 | $1,669 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $33 | $512 | $991 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $595 | $1,530 | $2,465 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $128 | $964 | $1,800 |