| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $67 | $119 | $199 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $137 | $192 | $303 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $119 | $167 | $262 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $122 | $205 | $349 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $58 | $98 | $167 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $93 | $150 | $246 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $114 | $161 | $255 |
| Group psychotherapy CPT 90853 • Mental Health | $45 | $58 | $67 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $1 | $6 | $11 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $26 | $195 | $407 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $16 | $168 | $320 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $83 | $170 | $318 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $139 | $248 | $304 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $71 | $427 | $857 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $21 | $93 | $155 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $74 | $208 | $403 |
| EMG needle each extremity complete CPT 95886 • Neurology | $37 | $77 | $117 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $37 | $115 | $225 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $59 | $96 | $123 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $26 | $184 | $342 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $94 | $237 | $450 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $95 | $270 | $457 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $41 | $122 | $165 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $9 | $164 | $255 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $128 | $202 | $348 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $168 | $304 | $441 |
| Office visit established patient minimal CPT 99211 • Office Visits | $3 | $34 | $52 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $40 | $88 | $128 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $59 | $141 | $207 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $111 | $151 | $230 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $40 | $254 | $412 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $8 | $152 | $228 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $112 | $238 | $307 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $160 | $348 | $451 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $62 | $78 | $88 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $40 | $119 | $162 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $110 | $189 | $233 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $30 | $116 | $163 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $113 | $194 | $238 |
| Consultation office low complexity CPT 99243 • Office Visits | $7 | $122 | $263 |
| Consultation office high complexity CPT 99245 • Office Visits | $16 | $332 | $499 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $98 | $688 | $1,474 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $14 | $51 | $111 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $876 | $1,533 | $2,848 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $31 | $265 | $500 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $609 | $1,349 | $2,627 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $374 | $651 | $1,204 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $175 | $306 | $567 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $277 | $1,040 | $1,803 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $81 | $697 | $1,314 |