| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $53 | $120 | $186 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $135 | $224 | $313 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $240 | $242 | $244 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $130 | $228 | $327 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $64 | $103 | $141 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $86 | $158 | $229 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $232 | $234 | $237 |
| Group psychotherapy CPT 90853 • Mental Health | $41 | $48 | $56 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $11 | $11 | $11 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $308 | $328 | $348 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $143 | $220 | $296 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $295 | $299 | $304 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $688 | $738 | $788 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $132 | $529 | $927 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $111 | $176 | $265 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $159 | $168 | $188 |
| EMG needle each extremity complete CPT 95886 • Neurology | $114 | $160 | $206 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $93 | $151 | $209 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $109 | $218 | $274 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $145 | $145 | $145 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $424 | $428 | $432 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $255 | $458 | $662 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $161 | $164 | $166 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $233 | $234 | $236 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $165 | $215 | $285 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $212 | $334 | $455 |
| Office visit established patient minimal CPT 99211 • Office Visits | $46 | $48 | $51 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $94 | $97 | $99 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $113 | $135 | $158 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $108 | $151 | $238 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $245 | $279 | $313 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $220 | $222 | $224 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $297 | $300 | $303 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $164 | $349 | $445 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $85 | $86 | $86 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $156 | $158 | $159 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $226 | $227 | $229 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $157 | $159 | $160 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $109 | $192 | $235 |
| Consultation office low complexity CPT 99243 • Office Visits | $129 | $171 | $213 |
| Consultation office high complexity CPT 99245 • Office Visits | $238 | $388 | $496 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $1,209 | $1,304 | $1,400 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $101 | $125 | $149 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $2,602 | $2,602 | $2,602 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $544 | $544 | $544 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,386 | $1,897 | $2,408 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $647 | $801 | $1,107 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $520 | $520 | $520 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $939 | $1,294 | $1,650 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $686 | $944 | $1,202 |