| Psychotherapy 45 minutes CPT 90834 • Mental Health | $103 | $154 | $213 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $92 | $130 | $189 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $127 | $136 | $148 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $105 | $177 | $273 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $124 | $212 | $301 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $56 | $108 | $159 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $150 | $208 | $241 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $103 | $124 | $142 |
| Group psychotherapy CPT 90853 • Mental Health | $33 | $48 | $63 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $7 | $11 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $203 | $203 | $204 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $42 | $171 | $301 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $134 | $204 | $296 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $326 | $403 | $518 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $596 | $781 | $967 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $61 | $79 | $109 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $31 | $86 | $157 |
| EMG needle each extremity complete CPT 95886 • Neurology | $128 | $174 | $220 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $79 | $148 | $216 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $80 | $96 | $109 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $72 | $128 | $179 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $71 | $185 | $249 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $227 | $298 | $382 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $107 | $128 | $170 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $112 | $178 | $242 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $139 | $247 | $370 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $212 | $287 | $383 |
| Office visit established patient minimal CPT 99211 • Office Visits | $25 | $34 | $38 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $65 | $83 | $102 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $65 | $117 | $146 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $42 | $144 | $206 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $179 | $258 | $303 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $126 | $167 | $230 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $129 | $152 | $174 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $30 | $264 | $459 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $64 | $90 | $116 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $116 | $129 | $164 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $116 | $139 | $164 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $90 | $108 | $116 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $110 | $147 | $175 |
| Consultation office low complexity CPT 99243 • Office Visits | $93 | $181 | $279 |
| Consultation office high complexity CPT 99245 • Office Visits | $42 | $176 | $280 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $544 | $892 | $1,240 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $40 | $72 | $104 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,140 | $1,908 | $2,675 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $377 | $377 | $377 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $811 | $1,147 | $1,484 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $374 | $664 | $1,135 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $676 | $676 | $676 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $1,339 | $1,339 | $1,339 |