| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $60 | $109 | $144 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $95 | $136 | $176 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $4 | $49 | $72 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $60 | $120 | $150 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $95 | $132 | $150 |
| Group psychotherapy CPT 90853 • Mental Health | $40 | $53 | $66 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $123 | $123 | $123 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $30 | $30 | $30 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $133 | $133 | $134 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $56 | $183 | $310 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $429 | $429 | $429 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $111 | $111 | $111 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $80 | $121 | $161 |
| EMG needle each extremity complete CPT 95886 • Neurology | $52 | $52 | $52 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $18 | $35 | $52 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $56 | $83 | $111 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $134 | $134 | $134 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $104 | $140 | $175 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $285 | $285 | $285 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $40 | $53 | $71 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $40 | $75 | $109 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $50 | $125 | $163 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $30 | $104 | $215 |
| Office visit established patient minimal CPT 99211 • Office Visits | $3 | $17 | $25 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $35 | $42 | $55 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $25 | $40 | $65 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $30 | $56 | $106 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $55 | $116 | $176 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $30 | $96 | $170 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $57 | $94 | $131 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $50 | $139 | $198 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $90 | $110 | $129 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $30 | $88 | $129 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $43 | $64 | $99 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $30 | $96 | $129 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $97 | $111 | $135 |
| Consultation office straightforward CPT 99241 • Office Visits | $25 | $25 | $25 |
| Consultation office low complexity CPT 99243 • Office Visits | $42 | $60 | $92 |
| Consultation office high complexity CPT 99245 • Office Visits | $66 | $164 | $213 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $601 | $601 | $601 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $19 | $28 | $37 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $30 | $539 | $1,047 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $362 | $422 | $482 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $30 | $211 | $391 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $30 | $59 | $88 |
| Retinal detachment repair with vitrectomy CPT 67108 • Ophthalmology | $571 | $856 | $1,141 |
| Retinal photocoagulation treatment CPT 67210 • Ophthalmology | $30 | $263 | $495 |
| Retinal treatment extensive photocoagulation CPT 67228 • Ophthalmology | $30 | $178 | $326 |
| Strabismus surgery one horizontal muscle CPT 67311 • Ophthalmology | $462 | $462 | $462 |
| Excision chalazion single CPT 67800 • Ophthalmology | $74 | $74 | $74 |