| Psychotherapy 60 minutes CPT 90837 • Mental Health | $110 | $150 | $196 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $151 | $173 | $191 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $196 | $245 | $295 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $153 | $153 | $153 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $80 | $111 | $145 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $110 | $142 | $160 |
| Group psychotherapy CPT 90853 • Mental Health | $23 | $31 | $45 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $6 | $10 | $16 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $70 | $224 | $363 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $235 | $259 | $271 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $174 | $209 | $264 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $80 | $241 | $359 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $80 | $300 | $606 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $52 | $52 | $52 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $64 | $64 | $64 |
| EMG needle each extremity complete CPT 95886 • Neurology | $60 | $109 | $137 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $76 | $76 | $76 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $162 | $174 | $206 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $100 | $139 | $197 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $147 | $198 | $286 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $412 | $461 | $533 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $88 | $170 | $321 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $145 | $227 | $384 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $185 | $265 | $379 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $269 | $349 | $532 |
| Office visit established patient minimal CPT 99211 • Office Visits | $14 | $26 | $33 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $28 | $44 | $61 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $71 | $148 | $247 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $115 | $129 | $147 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $186 | $197 | $208 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $92 | $136 | $158 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $153 | $171 | $185 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $243 | $283 | $347 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $46 | $78 | $120 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $76 | $96 | $127 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $123 | $142 | $159 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $85 | $102 | $110 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $131 | $154 | $183 |
| Consultation office low complexity CPT 99243 • Office Visits | $208 | $326 | $443 |
| Consultation office high complexity CPT 99245 • Office Visits | $302 | $427 | $709 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $797 | $797 | $797 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $88 | $88 | $88 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,649 | $1,649 | $1,649 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $433 | $433 | $433 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,633 | $1,633 | $1,633 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $696 | $696 | $696 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $564 | $564 | $564 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $1,251 | $1,251 | $1,251 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $729 | $1,091 | $1,482 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $240 | $240 | $240 |