| Psychotherapy 60 minutes CPT 90837 • Mental Health | $152 | $242 | $302 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $83 | $110 | $138 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $434 | $434 | $434 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $44 | $44 | $44 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $207 | $207 | $207 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $74 | $100 | $125 |
| Group psychotherapy CPT 90853 • Mental Health | $54 | $63 | $72 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $3 | $5 | $7 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $96 | $187 | $340 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $310 | $310 | $310 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $138 | $213 | $289 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $90 | $232 | $377 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $40 | $241 | $442 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $78 | $104 | $117 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $81 | $140 | $170 |
| EMG needle each extremity complete CPT 95886 • Neurology | $102 | $149 | $204 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $25 | $25 | $25 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $118 | $132 | $161 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $142 | $224 | $327 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $186 | $309 | $431 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $70 | $247 | $367 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $35 | $70 | $109 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $77 | $147 | $207 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $55 | $165 | $322 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $195 | $277 | $408 |
| Office visit established patient minimal CPT 99211 • Office Visits | $20 | $33 | $40 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $38 | $55 | $82 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $36 | $82 | $150 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $55 | $99 | $214 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $162 | $240 | $282 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $71 | $114 | $144 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $156 | $210 | $287 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $55 | $168 | $249 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $27 | $65 | $96 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $65 | $105 | $155 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $72 | $123 | $181 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $50 | $73 | $105 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $94 | $135 | $223 |
| Consultation office low complexity CPT 99243 • Office Visits | $84 | $120 | $138 |
| Consultation office high complexity CPT 99245 • Office Visits | $517 | $517 | $517 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $622 | $1,032 | $1,442 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $29 | $42 | $55 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $2,477 | $2,477 | $2,477 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $188 | $188 | $188 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $2,416 | $2,416 | $2,416 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $380 | $380 | $380 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $831 | $831 | $831 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $575 | $575 | $575 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $55 | $821 | $1,586 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $78 | $78 | $78 |