| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $233 | $233 | $233 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $279 | $279 | $279 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $443 | $443 | $443 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $1,263 | $1,263 | $1,263 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $182 | $182 | $182 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $274 | $274 | $274 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $312 | $312 | $312 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $517 | $517 | $517 |
| Office visit established patient minimal CPT 99211 • Office Visits | $23 | $23 | $23 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $63 | $63 | $63 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $183 | $183 | $183 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $263 | $263 | $263 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $353 | $353 | $353 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $243 | $243 | $243 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $326 | $326 | $326 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $477 | $477 | $477 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $93 | $93 | $93 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $170 | $170 | $170 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $245 | $245 | $245 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $173 | $173 | $173 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $252 | $252 | $252 |
| Consultation office low complexity CPT 99243 • Office Visits | $348 | $348 | $348 |
| Consultation office high complexity CPT 99245 • Office Visits | $628 | $628 | $628 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $1,632 | $1,632 | $1,632 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $92 | $92 | $92 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $3,017 | $3,017 | $3,017 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $635 | $635 | $635 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $2,803 | $2,803 | $2,803 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $1,295 | $1,295 | $1,295 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $775 | $775 | $775 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $1,916 | $1,916 | $1,916 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $1,396 | $1,396 | $1,396 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $252 | $252 | $252 |
| Retinal detachment repair with vitrectomy CPT 67108 • Ophthalmology | $3,054 | $3,054 | $3,054 |
| Retinal photocoagulation treatment CPT 67210 • Ophthalmology | $1,329 | $1,329 | $1,329 |
| Retinal treatment extensive photocoagulation CPT 67228 • Ophthalmology | $779 | $779 | $779 |
| Strabismus surgery one horizontal muscle CPT 67311 • Ophthalmology | $1,529 | $1,529 | $1,529 |
| Excision chalazion single CPT 67800 • Ophthalmology | $263 | $263 | $263 |
| Blepharoptosis repair levator resection CPT 67901 • Ophthalmology | $1,500 | $1,500 | $1,500 |
| Lacrimal punctum closure by plug CPT 68761 • Ophthalmology | $383 | $383 | $383 |
| Eye exam new patient intermediate CPT 92002 • Ophthalmology | $235 | $235 | $235 |
| Eye exam new patient comprehensive CPT 92004 • Ophthalmology | $417 | $417 | $417 |
| Eye exam established patient intermediate CPT 92012 • Ophthalmology | $142 | $142 | $142 |
| Eye exam established patient comprehensive CPT 92014 • Ophthalmology | $216 | $216 | $216 |
| Visual field examination CPT 92083 • Ophthalmology | $179 | $179 | $179 |
| Retinal imaging OCT posterior segment CPT 92134 • Ophthalmology | $45 | $45 | $45 |
| Ophthalmic biometry IOL power calculation CPT 92136 • Ophthalmology | $91 | $91 | $91 |
| Fundus photography CPT 92250 • Ophthalmology | $127 | $127 | $127 |
| Arthrocentesis aspiration small joint CPT 20600 • Orthopedics | $185 | $185 | $185 |
| Arthrocentesis aspiration intermediate joint CPT 20605 • Orthopedics | $138 | $138 | $138 |