| Psychotherapy 60 minutes CPT 90837 • Mental Health | $177 | $177 | $177 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $169 | $169 | $169 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $205 | $205 | $205 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $98 | $98 | $98 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $144 | $144 | $144 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $149 | $149 | $149 |
| Group psychotherapy CPT 90853 • Mental Health | $39 | $39 | $39 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $7 | $7 | $7 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $90 | $100 | $111 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $168 | $168 | $168 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $192 | $192 | $192 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $435 | $435 | $435 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $532 | $532 | $532 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $96 | $96 | $96 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $126 | $126 | $126 |
| EMG needle each extremity complete CPT 95886 • Neurology | $72 | $72 | $72 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $136 | $136 | $136 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $76 | $76 | $76 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $207 | $207 | $207 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $118 | $118 | $118 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $161 | $161 | $161 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $72 | $72 | $72 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $152 | $152 | $152 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $184 | $184 | $184 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $240 | $240 | $240 |
| Office visit established patient minimal CPT 99211 • Office Visits | $13 | $13 | $13 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $37 | $37 | $37 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $73 | $73 | $73 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $154 | $154 | $154 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $206 | $206 | $206 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $145 | $145 | $145 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $195 | $195 | $195 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $287 | $287 | $287 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $56 | $56 | $56 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $102 | $102 | $102 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $148 | $148 | $148 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $103 | $103 | $103 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $152 | $152 | $152 |
| Consultation office low complexity CPT 99243 • Office Visits | $138 | $138 | $138 |
| Consultation office high complexity CPT 99245 • Office Visits | $274 | $274 | $274 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $876 | $876 | $876 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $65 | $65 | $65 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,680 | $1,680 | $1,680 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $351 | $351 | $351 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,554 | $1,554 | $1,554 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $715 | $715 | $715 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $336 | $336 | $336 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $1,065 | $1,065 | $1,065 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $776 | $776 | $776 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $140 | $140 | $140 |