| Interactive complexity add-on CPT 90785 • Mental Health | $3 | $7 | $13 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $162 | $174 | $191 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $167 | $168 | $168 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $63 | $73 | $92 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $54 | $75 | $102 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $68 | $98 | $130 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $84 | $94 | $112 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $92 | $96 | $99 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $101 | $125 | $144 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $145 | $147 | $150 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $46 | $63 | $82 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $78 | $120 | $150 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $77 | $128 | $157 |
| Group psychotherapy CPT 90853 • Mental Health | $22 | $40 | $58 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $4 | $4 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $217 | $217 | $217 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $30 | $30 | $30 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $176 | $176 | $176 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $165 | $248 | $330 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $368 | $373 | $379 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $104 | $107 | $111 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $80 | $115 | $151 |
| EMG needle each extremity complete CPT 95886 • Neurology | $97 | $97 | $97 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $18 | $62 | $106 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $65 | $88 | $111 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $157 | $157 | $157 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $206 | $206 | $207 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $285 | $313 | $341 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $71 | $76 | $79 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $79 | $98 | $117 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $131 | $149 | $163 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $162 | $193 | $225 |
| Office visit established patient minimal CPT 99211 • Office Visits | $22 | $25 | $30 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $52 | $54 | $55 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $30 | $58 | $88 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $10 | $68 | $105 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $149 | $157 | $165 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $30 | $84 | $147 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $121 | $140 | $159 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $151 | $190 | $221 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $43 | $77 | $111 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $30 | $77 | $111 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $30 | $81 | $111 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $30 | $72 | $111 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $97 | $113 | $136 |
| Consultation office low complexity CPT 99243 • Office Visits | $49 | $53 | $56 |
| Consultation office high complexity CPT 99245 • Office Visits | $213 | $249 | $285 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $634 | $696 | $758 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $69 | $69 | $69 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,130 | $1,130 | $1,130 |