| Psychotherapy 60 minutes CPT 90837 • Mental Health | $107 | $107 | $107 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $98 | $98 | $98 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $154 | $154 | $154 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $80 | $80 | $80 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $75 | $75 | $75 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $87 | $87 | $87 |
| Group psychotherapy CPT 90853 • Mental Health | $26 | $26 | $26 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $4 | $4 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $69 | $145 | $222 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $131 | $184 | $237 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $112 | $190 | $240 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $81 | $274 | $609 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $145 | $430 | $715 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $67 | $67 | $67 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $97 | $97 | $97 |
| EMG needle each extremity complete CPT 95886 • Neurology | $77 | $119 | $160 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $83 | $83 | $83 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $58 | $58 | $58 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $54 | $132 | $219 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $93 | $182 | $286 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $267 | $267 | $267 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $45 | $89 | $115 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $65 | $115 | $165 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $100 | $186 | $245 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $126 | $238 | $324 |
| Office visit established patient minimal CPT 99211 • Office Visits | $13 | $28 | $37 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $26 | $66 | $89 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $32 | $103 | $143 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $65 | $108 | $154 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $88 | $177 | $265 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $64 | $122 | $156 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $87 | $142 | $196 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $129 | $225 | $287 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $26 | $41 | $56 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $48 | $87 | $110 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $68 | $106 | $148 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $47 | $88 | $112 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $69 | $110 | $152 |
| Consultation office low complexity CPT 99243 • Office Visits | $88 | $132 | $176 |
| Consultation office high complexity CPT 99245 • Office Visits | $160 | $240 | $319 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $446 | $762 | $1,078 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $40 | $54 | $67 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $855 | $1,433 | $2,010 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $244 | $334 | $424 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $845 | $1,357 | $1,869 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $451 | $657 | $864 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $291 | $348 | $404 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $769 | $1,021 | $1,272 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $551 | $740 | $929 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $154 | $155 | $156 |