| Psychotherapy 60 minutes CPT 90837 • Mental Health | $125 | $125 | $125 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $119 | $119 | $119 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $177 | $177 | $177 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $89 | $89 | $89 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $83 | $83 | $83 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $101 | $101 | $101 |
| Group psychotherapy CPT 90853 • Mental Health | $29 | $29 | $29 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $5 | $5 | $5 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $143 | $143 | $143 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $140 | $140 | $140 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $108 | $108 | $108 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $127 | $127 | $127 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $149 | $149 | $149 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $33 | $33 | $33 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $30 | $30 | $30 |
| EMG needle each extremity complete CPT 95886 • Neurology | $49 | $49 | $49 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $44 | $44 | $44 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $123 | $123 | $123 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $84 | $84 | $84 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $112 | $112 | $112 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $193 | $193 | $193 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $56 | $56 | $56 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $63 | $63 | $63 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $101 | $101 | $101 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $132 | $178 | $222 |
| Office visit established patient minimal CPT 99211 • Office Visits | $19 | $19 | $19 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $21 | $21 | $21 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $54 | $54 | $54 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $86 | $86 | $86 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $116 | $146 | $176 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $78 | $78 | $78 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $110 | $110 | $110 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $167 | $167 | $167 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $33 | $33 | $33 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $59 | $59 | $59 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $88 | $88 | $88 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $63 | $63 | $63 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $90 | $90 | $90 |
| Consultation office low complexity CPT 99243 • Office Visits | $116 | $116 | $116 |
| Consultation office high complexity CPT 99245 • Office Visits | $211 | $211 | $211 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $513 | $513 | $513 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $56 | $56 | $56 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,271 | $1,271 | $1,271 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $308 | $308 | $308 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $921 | $921 | $921 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $490 | $490 | $490 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $409 | $409 | $409 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $843 | $843 | $843 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $600 | $600 | $600 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $176 | $176 | $176 |