| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $102 | $144 | $211 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $164 | $221 | $324 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $165 | $233 | $278 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $298 | $317 | $336 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $143 | $151 | $162 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $99 | $171 | $263 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $110 | $225 | $271 |
| Group psychotherapy CPT 90853 • Mental Health | $25 | $40 | $65 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $5 | $8 | $13 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $83 | $168 | $259 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $109 | $233 | $436 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $146 | $267 | $390 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $80 | $203 | $383 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $145 | $369 | $517 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $106 | $201 | $296 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $152 | $178 | $203 |
| EMG needle each extremity complete CPT 95886 • Neurology | $64 | $127 | $224 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $68 | $97 | $134 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $106 | $138 | $167 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $79 | $136 | $183 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $150 | $171 | $187 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $277 | $326 | $412 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $73 | $115 | $144 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $115 | $156 | $210 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $116 | $174 | $258 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $153 | $268 | $403 |
| Office visit established patient minimal CPT 99211 • Office Visits | $23 | $31 | $39 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $32 | $58 | $84 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $69 | $101 | $142 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $88 | $133 | $210 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $188 | $223 | $281 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $77 | $150 | $200 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $119 | $209 | $272 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $122 | $240 | $401 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $45 | $64 | $78 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $72 | $104 | $143 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $108 | $151 | $205 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $75 | $105 | $143 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $80 | $136 | $211 |
| Consultation office low complexity CPT 99243 • Office Visits | $115 | $164 | $244 |
| Consultation office high complexity CPT 99245 • Office Visits | $207 | $266 | $382 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $610 | $1,064 | $1,518 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $37 | $108 | $179 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $982 | $2,102 | $3,851 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $170 | $644 | $1,118 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $3,954 | $3,954 | $3,954 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $497 | $1,287 | $2,076 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $198 | $512 | $970 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $622 | $1,423 | $2,661 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $455 | $1,106 | $2,135 |