| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $77 | $151 | $273 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $111 | $200 | $419 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $135 | $187 | $328 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $123 | $241 | $437 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $54 | $104 | $190 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $81 | $144 | $308 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $110 | $164 | $318 |
| Group psychotherapy CPT 90853 • Mental Health | $23 | $43 | $83 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $1 | $7 | $14 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $40 | $160 | $366 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $103 | $284 | $410 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $95 | $211 | $349 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $80 | $158 | $252 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $58 | $146 | $271 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $90 | $125 | $194 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $131 | $172 | $255 |
| EMG needle each extremity complete CPT 95886 • Neurology | $50 | $89 | $146 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $55 | $107 | $163 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $65 | $179 | $358 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $31 | $157 | $244 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $41 | $207 | $326 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $197 | $379 | $572 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $43 | $101 | $176 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $6 | $97 | $178 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $85 | $261 | $430 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $120 | $356 | $540 |
| Office visit established patient minimal CPT 99211 • Office Visits | $6 | $26 | $53 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $25 | $49 | $105 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $45 | $93 | $174 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $5 | $120 | $253 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $38 | $168 | $340 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $59 | $128 | $240 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $107 | $181 | $324 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $158 | $266 | $477 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $5 | $44 | $93 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $50 | $94 | $171 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $71 | $145 | $246 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $9 | $85 | $171 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $9 | $117 | $252 |
| Consultation office low complexity CPT 99243 • Office Visits | $43 | $210 | $374 |
| Consultation office high complexity CPT 99245 • Office Visits | $144 | $296 | $529 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $459 | $860 | $1,621 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $10 | $58 | $98 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $763 | $1,947 | $3,131 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $194 | $565 | $851 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $764 | $1,581 | $2,888 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $408 | $771 | $1,324 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $76 | $349 | $623 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $490 | $1,237 | $1,983 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $106 | $1,109 | $2,159 |