| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $123 | $143 | $163 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $71 | $71 | $72 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $93 | $101 | $109 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $86 | $100 | $114 |
| Group psychotherapy CPT 90853 • Mental Health | $22 | $22 | $23 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $3 | $3 | $3 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $16 | $90 | $164 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $14 | $86 | $158 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $83 | $109 | $135 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $50 | $151 | $252 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $54 | $163 | $271 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $53 | $72 | $90 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $85 | $108 | $131 |
| EMG needle each extremity complete CPT 95886 • Neurology | $97 | $97 | $97 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $55 | $80 | $104 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $69 | $99 | $129 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $31 | $57 | $82 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $102 | $152 | $203 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $333 | $333 | $334 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $34 | $45 | $57 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $83 | $83 | $83 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $10 | $10 | $10 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $16 | $16 | $16 |
| Office visit established patient minimal CPT 99211 • Office Visits | $3 | $9 | $16 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $32 | $32 | $33 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $32 | $43 | $53 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $40 | $57 | $73 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $15 | $56 | $98 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $12 | $45 | $78 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $54 | $80 | $107 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $79 | $119 | $158 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $3 | $18 | $32 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $58 | $58 | $59 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $83 | $83 | $84 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $9 | $33 | $58 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $64 | $74 | $85 |
| Consultation office low complexity CPT 99243 • Office Visits | $113 | $113 | $113 |
| Consultation office high complexity CPT 99245 • Office Visits | $85 | $144 | $203 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $229 | $365 | $501 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $34 | $49 | $65 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $763 | $763 | $763 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $138 | $138 | $138 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,091 | $1,091 | $1,091 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $582 | $582 | $583 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $76 | $76 | $76 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $34 | $34 | $34 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $705 | $705 | $705 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $34 | $34 | $34 |
| Retinal detachment repair with vitrectomy CPT 67108 • Ophthalmology | $1,112 | $1,112 | $1,112 |
| Retinal photocoagulation treatment CPT 67210 • Ophthalmology | $96 | $357 | $617 |