| Psychotherapy 45 minutes CPT 90834 • Mental Health | $77 | $146 | $285 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $91 | $141 | $224 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $100 | $213 | $419 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $105 | $186 | $331 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $139 | $227 | $402 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $69 | $106 | $178 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $90 | $162 | $273 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $83 | $166 | $285 |
| Group psychotherapy CPT 90853 • Mental Health | $44 | $54 | $76 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $0 | $7 | $13 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $12 | $234 | $421 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $111 | $204 | $375 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $33 | $225 | $431 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $100 | $332 | $695 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $450 | $795 | $1,220 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $60 | $199 | $312 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $142 | $270 | $448 |
| EMG needle each extremity complete CPT 95886 • Neurology | $88 | $144 | $191 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $41 | $108 | $179 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $129 | $187 | $226 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $83 | $206 | $374 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $186 | $298 | $355 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $325 | $569 | $801 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $20 | $94 | $126 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $94 | $164 | $203 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $40 | $212 | $408 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $203 | $301 | $445 |
| Office visit established patient minimal CPT 99211 • Office Visits | $33 | $39 | $47 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $3 | $59 | $88 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $88 | $122 | $142 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $98 | $167 | $262 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $22 | $230 | $368 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $8 | $124 | $183 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $40 | $192 | $288 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $195 | $300 | $385 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $67 | $82 | $110 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $9 | $108 | $175 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $8 | $159 | $264 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $72 | $126 | $179 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $13 | $157 | $253 |
| Consultation office low complexity CPT 99243 • Office Visits | $53 | $145 | $251 |
| Consultation office high complexity CPT 99245 • Office Visits | $200 | $333 | $468 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $588 | $1,236 | $1,577 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $37 | $80 | $123 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,575 | $2,442 | $3,730 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $46 | $423 | $651 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $766 | $2,087 | $3,454 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $471 | $1,033 | $1,595 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $44 | $497 | $947 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $40 | $854 | $2,356 |