| Psychotherapy 60 minutes CPT 90837 • Mental Health | $102 | $213 | $335 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $108 | $172 | $262 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $349 | $349 | $349 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $110 | $110 | $110 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $111 | $125 | $154 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $125 | $190 | $255 |
| Group psychotherapy CPT 90853 • Mental Health | $53 | $60 | $67 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $6 | $8 | $11 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $96 | $172 | $266 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $212 | $234 | $270 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $145 | $154 | $164 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $90 | $364 | $702 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $311 | $584 | $857 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $64 | $95 | $126 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $33 | $83 | $133 |
| EMG needle each extremity complete CPT 95886 • Neurology | $61 | $93 | $120 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $67 | $67 | $67 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $23 | $125 | $286 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $100 | $142 | $201 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $71 | $134 | $261 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $285 | $430 | $717 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $87 | $105 | $118 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $96 | $129 | $162 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $174 | $251 | $348 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $304 | $343 | $400 |
| Office visit established patient minimal CPT 99211 • Office Visits | $11 | $19 | $34 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $44 | $61 | $86 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $84 | $109 | $158 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $95 | $155 | $214 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $172 | $238 | $303 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $79 | $126 | $149 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $131 | $163 | $186 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $151 | $271 | $434 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $40 | $51 | $64 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $65 | $97 | $121 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $92 | $138 | $170 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $82 | $102 | $119 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $81 | $163 | $229 |
| Consultation office low complexity CPT 99243 • Office Visits | $140 | $170 | $211 |
| Consultation office high complexity CPT 99245 • Office Visits | $201 | $304 | $499 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $799 | $1,137 | $1,474 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $89 | $90 | $91 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,574 | $2,211 | $2,848 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $277 | $341 | $406 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,218 | $1,333 | $1,448 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $610 | $704 | $850 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $388 | $403 | $418 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $1,056 | $1,116 | $1,176 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $848 | $867 | $885 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $135 | $189 | $244 |