| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $67 | $125 | $233 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $144 | $216 | $356 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $102 | $181 | $307 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $107 | $206 | $347 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $61 | $104 | $178 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $81 | $144 | $268 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $114 | $175 | $298 |
| Group psychotherapy CPT 90853 • Mental Health | $23 | $53 | $71 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $1 | $7 | $13 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $16 | $184 | $407 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $24 | $187 | $385 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $14 | $175 | $377 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $58 | $327 | $921 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $153 | $213 | $271 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $18 | $82 | $137 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $26 | $128 | $226 |
| EMG needle each extremity complete CPT 95886 • Neurology | $97 | $110 | $125 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $52 | $99 | $142 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $69 | $173 | $321 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $72 | $176 | $383 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $41 | $196 | $285 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $67 | $275 | $418 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $30 | $99 | $165 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $51 | $168 | $255 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $128 | $266 | $381 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $24 | $304 | $505 |
| Office visit established patient minimal CPT 99211 • Office Visits | $1 | $26 | $52 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $15 | $59 | $128 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $6 | $108 | $207 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $11 | $102 | $210 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $64 | $254 | $412 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $39 | $141 | $228 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $16 | $190 | $307 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $79 | $284 | $451 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $24 | $62 | $88 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $50 | $114 | $162 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $63 | $161 | $233 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $59 | $116 | $163 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $85 | $169 | $238 |
| Consultation office low complexity CPT 99243 • Office Visits | $86 | $180 | $238 |
| Consultation office high complexity CPT 99245 • Office Visits | $203 | $379 | $499 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $321 | $864 | $1,770 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $38 | $89 | $163 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $763 | $2,107 | $3,452 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $34 | $375 | $716 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $109 | $1,461 | $3,183 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $408 | $953 | $1,869 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $84 | $396 | $686 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $490 | $1,402 | $2,313 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $352 | $1,106 | $1,860 |