| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $63 | $63 | $63 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $107 | $107 | $107 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $222 | $222 | $222 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $172 | $172 | $172 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $483 | $483 | $483 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $117 | $117 | $117 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $170 | $170 | $170 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $262 | $262 | $262 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $270 | $270 | $270 |
| Office visit established patient minimal CPT 99211 • Office Visits | $31 | $31 | $31 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $68 | $68 | $68 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $115 | $115 | $115 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $170 | $170 | $170 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $178 | $178 | $178 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $162 | $162 | $162 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $221 | $221 | $221 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $325 | $325 | $325 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $63 | $63 | $63 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $116 | $116 | $116 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $167 | $167 | $167 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $116 | $116 | $116 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $171 | $171 | $171 |
| Consultation office low complexity CPT 99243 • Office Visits | $157 | $157 | $157 |
| Consultation office high complexity CPT 99245 • Office Visits | $360 | $360 | $360 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $475 | $736 | $1,170 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $50 | $370 | $650 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $475 | $1,003 | $2,239 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $350 | $575 | $650 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $475 | $945 | $2,298 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $475 | $726 | $1,207 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $350 | $553 | $650 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $475 | $830 | $1,547 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $475 | $733 | $1,241 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $197 | $464 | $650 |
| Retinal detachment repair with vitrectomy CPT 67108 • Ophthalmology | $475 | $1,106 | $3,106 |
| Retinal photocoagulation treatment CPT 67210 • Ophthalmology | $350 | $659 | $997 |
| Retinal treatment extensive photocoagulation CPT 67228 • Ophthalmology | $350 | $813 | $1,941 |
| Strabismus surgery one horizontal muscle CPT 67311 • Ophthalmology | $475 | $735 | $1,163 |
| Excision chalazion single CPT 67800 • Ophthalmology | $244 | $474 | $650 |
| Blepharoptosis repair levator resection CPT 67901 • Ophthalmology | $475 | $775 | $1,451 |
| Lacrimal punctum closure by plug CPT 68761 • Ophthalmology | $50 | $364 | $650 |
| Eye exam new patient intermediate CPT 92002 • Ophthalmology | $130 | $130 | $130 |
| Eye exam new patient comprehensive CPT 92004 • Ophthalmology | $238 | $238 | $238 |
| Eye exam established patient intermediate CPT 92012 • Ophthalmology | $136 | $136 | $136 |
| Eye exam established patient comprehensive CPT 92014 • Ophthalmology | $198 | $198 | $198 |
| Visual field examination CPT 92083 • Ophthalmology | $55 | $55 | $55 |
| Retinal imaging OCT posterior segment CPT 92134 • Ophthalmology | $48 | $48 | $48 |
| Ophthalmic biometry IOL power calculation CPT 92136 • Ophthalmology | $90 | $90 | $90 |
| Fundus photography CPT 92250 • Ophthalmology | $84 | $84 | $84 |
| Arthrocentesis aspiration small joint CPT 20600 • Orthopedics | $90 | $391 | $650 |