| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $148 | $275 | $339 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $186 | $274 | $353 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $65 | $123 | $163 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $94 | $120 | $167 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $77 | $126 | $216 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $153 | $182 | $211 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $142 | $232 | $322 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $108 | $179 | $277 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $109 | $224 | $339 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $147 | $155 | $162 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $74 | $147 | $263 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $74 | $141 | $269 |
| Group psychotherapy CPT 90853 • Mental Health | $25 | $46 | $67 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $8 | $10 | $13 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $70 | $3,615 | $19,682 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $30 | $214 | $436 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $57 | $227 | $350 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $56 | $329 | $851 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $80 | $526 | $971 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $123 | $127 | $130 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $161 | $182 | $203 |
| EMG needle each extremity complete CPT 95886 • Neurology | $117 | $124 | $131 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $45 | $89 | $134 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $65 | $132 | $167 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $112 | $130 | $145 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $147 | $197 | $267 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $277 | $325 | $412 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $71 | $106 | $144 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $145 | $177 | $210 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $24 | $190 | $323 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $200 | $272 | $334 |
| Office visit established patient minimal CPT 99211 • Office Visits | $18 | $26 | $31 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $30 | $58 | $84 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $30 | $81 | $142 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $108 | $148 | $210 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $195 | $207 | $219 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $30 | $122 | $200 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $185 | $229 | $272 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $96 | $243 | $401 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $68 | $73 | $78 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $30 | $91 | $143 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $30 | $125 | $205 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $30 | $90 | $143 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $110 | $169 | $211 |
| Consultation office low complexity CPT 99243 • Office Visits | $30 | $119 | $194 |
| Consultation office high complexity CPT 99245 • Office Visits | $92 | $281 | $445 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $721 | $9,567 | $42,765 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $50 | $198 | $328 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $328 | $2,437 | $4,750 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $57 | $454 | $904 |