| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $160 | $271 | $339 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $52 | $103 | $131 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $54 | $96 | $120 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $87 | $137 | $173 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $115 | $134 | $152 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $111 | $196 | $255 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $136 | $179 | $201 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $186 | $225 | $244 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $91 | $107 | $121 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $125 | $153 | $167 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $131 | $159 | $174 |
| Group psychotherapy CPT 90853 • Mental Health | $35 | $43 | $46 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $5 | $6 | $8 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $296 | $5,370 | $19,682 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $57 | $324 | $750 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $57 | $415 | $750 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $477 | $586 | $640 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $549 | $678 | $742 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $75 | $152 | $190 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $100 | $215 | $272 |
| EMG needle each extremity complete CPT 95886 • Neurology | $118 | $149 | $165 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $111 | $138 | $152 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $56 | $145 | $190 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $68 | $143 | $228 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $86 | $227 | $298 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $352 | $442 | $487 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $52 | $80 | $94 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $111 | $135 | $145 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $155 | $195 | $216 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $200 | $230 | $286 |
| Office visit established patient minimal CPT 99211 • Office Visits | $23 | $28 | $30 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $39 | $56 | $73 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $52 | $93 | $117 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $102 | $136 | $166 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $121 | $203 | $233 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $71 | $115 | $186 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $121 | $155 | $170 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $161 | $208 | $227 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $61 | $63 | $65 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $58 | $101 | $141 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $103 | $140 | $156 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $75 | $97 | $105 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $106 | $137 | $150 |
| Consultation office low complexity CPT 99243 • Office Visits | $110 | $135 | $148 |
| Consultation office high complexity CPT 99245 • Office Visits | $261 | $271 | $277 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $519 | $9,204 | $42,765 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $57 | $413 | $750 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $519 | $1,881 | $4,750 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $57 | $299 | $655 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $519 | $6,352 | $33,816 |