| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $115 | $130 | $145 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $101 | $129 | $157 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $144 | $159 | $174 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $176 | $193 | $210 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $95 | $103 | $111 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $112 | $138 | $163 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $95 | $123 | $150 |
| Group psychotherapy CPT 90853 • Mental Health | $27 | $52 | $77 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $7 | $7 | $7 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $206 | $206 | $206 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $132 | $185 | $237 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $197 | $197 | $197 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $92 | $229 | $367 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $147 | $147 | $147 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $111 | $149 | $186 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $81 | $125 | $161 |
| EMG needle each extremity complete CPT 95886 • Neurology | $87 | $87 | $87 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $63 | $63 | $63 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $55 | $83 | $112 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $55 | $61 | $66 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $98 | $98 | $98 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $476 | $476 | $476 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $70 | $75 | $80 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $109 | $114 | $120 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $81 | $90 | $99 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $90 | $208 | $325 |
| Office visit established patient minimal CPT 99211 • Office Visits | $21 | $26 | $30 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $57 | $64 | $70 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $81 | $85 | $88 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $58 | $82 | $125 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $75 | $126 | $176 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $161 | $166 | $170 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $103 | $137 | $170 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $144 | $180 | $198 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $31 | $80 | $129 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $51 | $90 | $129 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $72 | $101 | $129 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $115 | $122 | $129 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $89 | $109 | $130 |
| Consultation office low complexity CPT 99243 • Office Visits | $30 | $99 | $171 |
| Consultation office high complexity CPT 99245 • Office Visits | $184 | $197 | $211 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $419 | $419 | $419 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $8 | $38 | $69 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,048 | $1,048 | $1,048 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $367 | $367 | $367 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,628 | $1,628 | $1,628 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $483 | $614 | $746 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $30 | $210 | $390 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $923 | $923 | $923 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $521 | $606 | $692 |