| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $309 | $325 | $341 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $466 | $521 | $576 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $158 | $326 | $495 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $167 | $384 | $600 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $261 | $275 | $288 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $376 | $396 | $415 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $132 | $282 | $433 |
| Group psychotherapy CPT 90853 • Mental Health | $104 | $109 | $115 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $14 | $23 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $184 | $356 | $528 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $42 | $515 | $991 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $152 | $293 | $434 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $323 | $972 | $1,620 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $370 | $1,026 | $1,682 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $107 | $298 | $483 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $353 | $577 | $689 |
| EMG needle each extremity complete CPT 95886 • Neurology | $79 | $137 | $194 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $83 | $135 | $186 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $103 | $291 | $484 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $265 | $277 | $289 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $168 | $314 | $459 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $259 | $785 | $1,311 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $92 | $108 | $124 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $130 | $207 | $284 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $42 | $271 | $390 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $42 | $343 | $496 |
| Office visit established patient minimal CPT 99211 • Office Visits | $28 | $45 | $61 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $55 | $86 | $116 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $90 | $109 | $128 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $30 | $80 | $181 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $174 | $256 | $338 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $148 | $200 | $252 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $164 | $251 | $339 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $239 | $424 | $538 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $96 | $106 | $115 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $115 | $146 | $176 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $123 | $188 | $254 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $115 | $147 | $179 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $126 | $224 | $285 |
| Consultation office low complexity CPT 99243 • Office Visits | $264 | $304 | $340 |
| Consultation office high complexity CPT 99245 • Office Visits | $269 | $481 | $619 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $512 | $1,103 | $1,694 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $81 | $101 | $121 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $3,131 | $5,756 | $8,382 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $326 | $438 | $550 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,155 | $2,032 | $2,909 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $763 | $1,902 | $3,598 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $42 | $423 | $805 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $1,988 | $1,988 | $1,988 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $1,449 | $2,664 | $3,879 |