| Psychotherapy 30 minutes CPT 90832 • Mental Health | $61 | $83 | $96 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $40 | $81 | $102 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $79 | $113 | $130 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $66 | $99 | $116 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $116 | $150 | $184 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $106 | $127 | $166 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $177 | $189 | $200 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $72 | $81 | $92 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $80 | $119 | $150 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $100 | $117 | $150 |
| Group psychotherapy CPT 90853 • Mental Health | $30 | $54 | $77 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $5 | $5 | $5 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $74 | $124 | $173 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $30 | $96 | $162 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $110 | $123 | $134 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $262 | $333 | $372 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $357 | $391 | $425 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $48 | $99 | $124 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $76 | $110 | $174 |
| EMG needle each extremity complete CPT 95886 • Neurology | $46 | $68 | $91 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $40 | $60 | $96 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $48 | $99 | $125 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $75 | $105 | $134 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $74 | $148 | $196 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $179 | $252 | $292 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $62 | $67 | $71 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $96 | $98 | $100 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $30 | $105 | $164 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $111 | $190 | $304 |
| Office visit established patient minimal CPT 99211 • Office Visits | $9 | $24 | $34 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $30 | $40 | $49 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $30 | $58 | $78 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $30 | $53 | $99 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $134 | $144 | $154 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $30 | $90 | $146 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $128 | $163 | $197 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $96 | $192 | $291 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $37 | $60 | $84 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $30 | $68 | $105 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $30 | $92 | $150 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $30 | $68 | $106 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $99 | $137 | $156 |
| Consultation office low complexity CPT 99243 • Office Visits | $30 | $50 | $91 |
| Consultation office high complexity CPT 99245 • Office Visits | $208 | $287 | $326 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $467 | $523 | $579 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $30 | $40 | $51 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,084 | $1,084 | $1,084 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $318 | $318 | $318 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $30 | $784 | $1,206 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $483 | $570 | $645 |