| Psychotherapy 60 minutes CPT 90837 • Mental Health | $135 | $135 | $135 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $125 | $125 | $125 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $170 | $170 | $170 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $88 | $88 | $88 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $101 | $101 | $101 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $124 | $124 | $124 |
| Group psychotherapy CPT 90853 • Mental Health | $34 | $45 | $56 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $7 | $7 | $7 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $95 | $251 | $407 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $261 | $261 | $261 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $190 | $190 | $190 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $65 | $65 | $65 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $125 | $125 | $125 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $58 | $58 | $58 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $93 | $93 | $93 |
| EMG needle each extremity complete CPT 95886 • Neurology | $114 | $114 | $114 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $60 | $60 | $60 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $73 | $73 | $73 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $93 | $93 | $93 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $125 | $125 | $125 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $387 | $387 | $387 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $67 | $81 | $88 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $84 | $92 | $100 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $138 | $150 | $164 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $158 | $171 | $181 |
| Office visit established patient minimal CPT 99211 • Office Visits | $9 | $25 | $43 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $24 | $45 | $63 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $35 | $58 | $89 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $83 | $112 | $126 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $43 | $82 | $122 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $67 | $147 | $228 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $110 | $209 | $307 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $154 | $302 | $451 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $33 | $61 | $88 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $55 | $108 | $162 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $77 | $155 | $233 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $70 | $117 | $163 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $95 | $167 | $238 |
| Consultation office low complexity CPT 99243 • Office Visits | $126 | $171 | $217 |
| Consultation office high complexity CPT 99245 • Office Visits | $227 | $363 | $499 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $577 | $721 | $864 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $89 | $89 | $89 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,406 | $1,406 | $1,406 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $444 | $444 | $444 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,321 | $1,321 | $1,321 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $707 | $707 | $707 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $532 | $532 | $532 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $1,242 | $1,242 | $1,242 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $935 | $935 | $935 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $284 | $284 | $284 |