| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $111 | $122 | $132 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $85 | $98 | $112 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $77 | $114 | $150 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $80 | $127 | $173 |
| Group psychotherapy CPT 90853 • Mental Health | $19 | $24 | $29 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $6 | $8 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $30 | $128 | $226 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $14 | $59 | $103 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $94 | $156 | $218 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $279 | $295 | $311 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $56 | $75 | $94 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $40 | $42 | $43 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $64 | $75 | $87 |
| EMG needle each extremity complete CPT 95886 • Neurology | $39 | $46 | $53 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $45 | $56 | $67 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $41 | $53 | $65 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $62 | $96 | $131 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $133 | $154 | $175 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $285 | $296 | $307 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $39 | $40 | $41 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $10 | $66 | $122 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $163 | $214 | $264 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $18 | $176 | $333 |
| Office visit established patient minimal CPT 99211 • Office Visits | $7 | $14 | $22 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $3 | $19 | $35 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $102 | $111 | $120 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $83 | $102 | $122 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $12 | $61 | $111 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $164 | $167 | $171 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $105 | $110 | $114 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $86 | $120 | $155 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $30 | $32 | $34 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $80 | $98 | $116 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $80 | $97 | $114 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $56 | $57 | $58 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $15 | $94 | $172 |
| Consultation office low complexity CPT 99243 • Office Visits | $9 | $83 | $156 |
| Consultation office high complexity CPT 99245 • Office Visits | $92 | $227 | $363 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $80 | $483 | $886 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $7 | $33 | $59 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,131 | $1,519 | $1,906 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $181 | $290 | $398 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $786 | $812 | $837 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $362 | $374 | $385 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $227 | $355 | $484 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $453 | $514 | $574 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $78 | $479 | $881 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $13 | $88 | $163 |
| Retinal detachment repair with vitrectomy CPT 67108 • Ophthalmology | $721 | $1,326 | $1,931 |
| Retinal photocoagulation treatment CPT 67210 • Ophthalmology | $72 | $453 | $835 |