| Psychotherapy 45 minutes CPT 90834 • Mental Health | $129 | $160 | $192 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $115 | $138 | $160 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $100 | $188 | $281 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $117 | $188 | $259 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $143 | $280 | $416 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $71 | $143 | $216 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $112 | $161 | $211 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $101 | $177 | $253 |
| Group psychotherapy CPT 90853 • Mental Health | $18 | $47 | $77 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $7 | $12 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $126 | $273 | $419 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $121 | $262 | $404 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $123 | $196 | $268 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $360 | $363 | $366 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $417 | $428 | $439 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $105 | $128 | $175 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $150 | $181 | $245 |
| EMG needle each extremity complete CPT 95886 • Neurology | $90 | $148 | $205 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $85 | $153 | $222 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $105 | $161 | $274 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $328 | $328 | $328 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $165 | $298 | $432 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $270 | $490 | $710 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $55 | $88 | $136 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $86 | $134 | $203 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $130 | $216 | $290 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $171 | $248 | $369 |
| Office visit established patient minimal CPT 99211 • Office Visits | $17 | $27 | $45 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $43 | $60 | $80 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $70 | $84 | $111 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $82 | $114 | $175 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $139 | $193 | $257 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $64 | $105 | $145 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $101 | $152 | $242 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $134 | $192 | $337 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $38 | $52 | $73 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $61 | $85 | $120 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $92 | $124 | $171 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $62 | $105 | $148 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $88 | $121 | $203 |
| Consultation office low complexity CPT 99243 • Office Visits | $96 | $160 | $256 |
| Consultation office high complexity CPT 99245 • Office Visits | $180 | $278 | $472 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $530 | $906 | $1,499 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $38 | $85 | $133 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $2,210 | $2,210 | $2,210 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $233 | $485 | $736 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,084 | $1,733 | $2,383 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $500 | $691 | $1,072 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $284 | $538 | $792 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $680 | $1,280 | $1,880 |