| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $67 | $148 | $286 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $142 | $264 | $480 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $90 | $189 | $341 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $122 | $232 | $410 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $53 | $114 | $228 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $82 | $168 | $314 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $86 | $175 | $326 |
| Group psychotherapy CPT 90853 • Mental Health | $20 | $45 | $87 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $3 | $9 | $14 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $12 | $199 | $422 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $137 | $217 | $376 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $24 | $197 | $433 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $194 | $551 | $1,206 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $214 | $567 | $1,217 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $45 | $164 | $358 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $131 | $258 | $513 |
| EMG needle each extremity complete CPT 95886 • Neurology | $97 | $171 | $311 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $21 | $81 | $118 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $26 | $122 | $211 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $151 | $220 | $255 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $198 | $321 | $562 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $67 | $439 | $918 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $36 | $83 | $157 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $8 | $111 | $243 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $30 | $171 | $362 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $111 | $251 | $478 |
| Office visit established patient minimal CPT 99211 • Office Visits | $7 | $22 | $44 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $20 | $40 | $69 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $53 | $99 | $175 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $30 | $102 | $247 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $57 | $167 | $347 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $8 | $89 | $181 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $107 | $171 | $285 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $158 | $240 | $380 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $32 | $68 | $109 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $58 | $99 | $173 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $83 | $146 | $261 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $58 | $101 | $177 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $13 | $116 | $250 |
| Consultation office low complexity CPT 99243 • Office Visits | $73 | $135 | $248 |
| Consultation office high complexity CPT 99245 • Office Visits | $144 | $248 | $398 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $75 | $854 | $1,985 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $5 | $62 | $115 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $763 | $2,251 | $3,740 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $34 | $407 | $781 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $764 | $1,773 | $3,463 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $408 | $863 | $1,600 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $189 | $452 | $748 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $687 | $1,524 | $2,362 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $705 | $1,215 | $1,724 |