| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $133 | $160 | $180 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $63 | $76 | $93 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $40 | $83 | $105 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $72 | $95 | $130 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $100 | $105 | $116 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $166 | $171 | $176 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $92 | $121 | $162 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $96 | $172 | $248 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $70 | $98 | $128 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $78 | $116 | $150 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $76 | $126 | $152 |
| Group psychotherapy CPT 90853 • Mental Health | $28 | $29 | $30 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $5 | $7 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $203 | $494 | $623 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $105 | $399 | $623 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $69 | $383 | $623 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $331 | $458 | $678 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $297 | $543 | $790 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $111 | $113 | $115 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $58 | $109 | $161 |
| EMG needle each extremity complete CPT 95886 • Neurology | $82 | $124 | $166 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $38 | $38 | $39 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $75 | $93 | $112 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $116 | $162 | $236 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $99 | $137 | $175 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $285 | $410 | $501 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $53 | $59 | $71 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $80 | $91 | $112 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $96 | $139 | $166 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $131 | $169 | $222 |
| Office visit established patient minimal CPT 99211 • Office Visits | $10 | $20 | $24 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $23 | $32 | $52 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $52 | $69 | $119 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $78 | $134 | $321 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $119 | $130 | $156 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $81 | $102 | $133 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $123 | $136 | $169 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $96 | $159 | $180 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $38 | $52 | $80 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $62 | $77 | $119 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $89 | $104 | $163 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $30 | $85 | $131 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $138 | $161 | $180 |
| Consultation office low complexity CPT 99243 • Office Visits | $30 | $83 | $137 |
| Consultation office high complexity CPT 99245 • Office Visits | $248 | $273 | $298 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $758 | $1,217 | $1,497 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $45 | $48 | $51 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,458 | $1,932 | $2,964 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $185 | $431 | $755 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,046 | $1,308 | $1,719 |