| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $53 | $102 | $193 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $107 | $132 | $157 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $98 | $176 | $284 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $154 | $250 | $345 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $80 | $110 | $153 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $75 | $80 | $86 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $90 | $91 | $93 |
| Group psychotherapy CPT 90853 • Mental Health | $18 | $21 | $25 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $4 | $4 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $132 | $243 | $354 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $115 | $192 | $316 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $112 | $238 | $363 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $136 | $406 | $904 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $45 | $238 | $430 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $67 | $97 | $111 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $84 | $113 | $159 |
| EMG needle each extremity complete CPT 95886 • Neurology | $35 | $134 | $233 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $37 | $62 | $87 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $45 | $88 | $109 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $54 | $63 | $73 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $71 | $113 | $162 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $267 | $273 | $278 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $32 | $107 | $173 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $65 | $121 | $177 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $81 | $109 | $124 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $126 | $212 | $349 |
| Office visit established patient minimal CPT 99211 • Office Visits | $6 | $17 | $36 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $26 | $84 | $135 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $43 | $134 | $217 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $30 | $129 | $307 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $70 | $126 | $182 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $64 | $132 | $200 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $87 | $148 | $208 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $129 | $201 | $278 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $26 | $53 | $79 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $48 | $95 | $127 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $68 | $129 | $190 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $47 | $95 | $129 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $69 | $118 | $183 |
| Consultation office low complexity CPT 99243 • Office Visits | $88 | $132 | $181 |
| Consultation office high complexity CPT 99245 • Office Visits | $119 | $206 | $338 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $412 | $1,039 | $1,666 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $34 | $63 | $104 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $855 | $1,169 | $1,482 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $244 | $244 | $244 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $845 | $1,876 | $2,908 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $451 | $814 | $1,343 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $320 | $320 | $320 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $769 | $854 | $939 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $551 | $619 | $686 |