| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $50 | $94 | $116 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $89 | $107 | $126 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $73 | $108 | $144 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $108 | $142 | $176 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $47 | $65 | $85 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $72 | $113 | $134 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $75 | $125 | $150 |
| Group psychotherapy CPT 90853 • Mental Health | $15 | $34 | $52 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $4 | $4 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $39 | $81 | $123 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $97 | $114 | $132 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $83 | $116 | $134 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $183 | $239 | $310 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $42 | $235 | $429 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $48 | $90 | $111 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $32 | $81 | $161 |
| EMG needle each extremity complete CPT 95886 • Neurology | $28 | $63 | $97 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $45 | $67 | $89 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $56 | $80 | $111 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $104 | $119 | $134 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $78 | $114 | $175 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $85 | $218 | $285 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $56 | $64 | $74 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $44 | $55 | $66 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $93 | $100 | $107 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $154 | $158 | $160 |
| Office visit established patient minimal CPT 99211 • Office Visits | $4 | $21 | $44 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $32 | $40 | $44 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $44 | $47 | $53 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $44 | $64 | $77 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $89 | $133 | $176 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $76 | $108 | $152 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $102 | $127 | $152 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $19 | $127 | $212 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $24 | $70 | $115 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $44 | $76 | $115 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $50 | $81 | $115 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $10 | $60 | $115 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $76 | $112 | $130 |
| Consultation office low complexity CPT 99243 • Office Visits | $58 | $67 | $76 |
| Consultation office high complexity CPT 99245 • Office Visits | $161 | $213 | $272 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $409 | $505 | $601 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $7 | $28 | $44 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $724 | $927 | $1,130 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $184 | $184 | $184 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $670 | $922 | $1,048 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $308 | $384 | $482 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $214 | $214 | $214 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $559 | $559 | $559 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $391 | $538 | $814 |