| Psychotherapy 60 minutes CPT 90837 • Mental Health | $152 | $227 | $302 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $83 | $110 | $138 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $101 | $101 | $101 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $225 | $225 | $225 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $72 | $72 | $72 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $74 | $74 | $74 |
| Group psychotherapy CPT 90853 • Mental Health | $19 | $30 | $41 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $5 | $8 | $11 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $51 | $87 | $123 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $347 | $347 | $347 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $106 | $122 | $138 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $188 | $283 | $377 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $128 | $285 | $442 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $41 | $92 | $117 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $82 | $121 | $170 |
| EMG needle each extremity complete CPT 95886 • Neurology | $32 | $67 | $102 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $37 | $37 | $37 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $112 | $116 | $118 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $85 | $90 | $95 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $51 | $118 | $186 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $131 | $217 | $303 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $35 | $50 | $65 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $77 | $142 | $207 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $111 | $149 | $185 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $141 | $190 | $230 |
| Office visit established patient minimal CPT 99211 • Office Visits | $15 | $17 | $20 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $38 | $46 | $54 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $61 | $99 | $137 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $55 | $125 | $207 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $162 | $222 | $282 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $144 | $177 | $210 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $96 | $126 | $156 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $55 | $141 | $229 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $27 | $62 | $96 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $65 | $110 | $155 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $72 | $95 | $117 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $65 | $109 | $153 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $94 | $146 | $223 |
| Consultation office low complexity CPT 99243 • Office Visits | $104 | $157 | $228 |
| Consultation office high complexity CPT 99245 • Office Visits | $517 | $517 | $517 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $622 | $1,032 | $1,442 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $29 | $42 | $55 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $911 | $911 | $911 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $188 | $188 | $188 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $835 | $835 | $835 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $1,286 | $1,286 | $1,286 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $180 | $180 | $180 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $575 | $575 | $575 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $419 | $507 | $595 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $76 | $76 | $76 |