| Psychotherapy 60 minutes CPT 90837 • Mental Health | $97 | $126 | $152 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $104 | $120 | $138 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $145 | $145 | $145 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $48 | $48 | $48 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $112 | $112 | $112 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $74 | $74 | $74 |
| Group psychotherapy CPT 90853 • Mental Health | $28 | $37 | $46 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $5 | $5 | $5 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $64 | $119 | $170 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $139 | $139 | $139 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $116 | $131 | $138 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $63 | $272 | $377 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $63 | $315 | $442 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $54 | $83 | $117 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $82 | $115 | $170 |
| EMG needle each extremity complete CPT 95886 • Neurology | $49 | $71 | $102 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $63 | $63 | $63 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $47 | $94 | $118 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $88 | $115 | $142 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $51 | $141 | $186 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $103 | $204 | $303 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $65 | $70 | $79 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $77 | $96 | $115 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $55 | $127 | $176 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $118 | $182 | $230 |
| Office visit established patient minimal CPT 99211 • Office Visits | $10 | $18 | $24 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $38 | $42 | $46 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $36 | $53 | $61 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $55 | $81 | $114 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $98 | $127 | $162 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $71 | $102 | $144 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $96 | $128 | $156 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $55 | $141 | $229 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $35 | $58 | $96 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $65 | $69 | $78 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $72 | $92 | $117 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $65 | $75 | $82 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $94 | $110 | $119 |
| Consultation office low complexity CPT 99243 • Office Visits | $104 | $116 | $138 |
| Consultation office high complexity CPT 99245 • Office Visits | $135 | $135 | $135 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $55 | $365 | $622 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $35 | $48 | $55 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,271 | $1,271 | $1,271 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $160 | $160 | $160 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,282 | $1,282 | $1,282 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $380 | $380 | $380 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $314 | $314 | $314 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $575 | $575 | $575 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $595 | $625 | $685 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $109 | $109 | $109 |