| Psychotherapy 60 minutes CPT 90837 • Mental Health | $152 | $152 | $152 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $121 | $121 | $121 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $146 | $146 | $146 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $73 | $73 | $73 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $97 | $97 | $97 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $102 | $102 | $102 |
| Group psychotherapy CPT 90853 • Mental Health | $24 | $24 | $24 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $5 | $5 | $5 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $146 | $146 | $146 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $138 | $138 | $138 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $110 | $110 | $110 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $394 | $394 | $394 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $454 | $454 | $454 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $50 | $50 | $50 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $159 | $159 | $159 |
| EMG needle each extremity complete CPT 95886 • Neurology | $52 | $52 | $52 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $52 | $52 | $52 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $112 | $112 | $112 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $57 | $57 | $57 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $175 | $175 | $175 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $284 | $284 | $284 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $47 | $47 | $47 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $81 | $181 | $281 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $167 | $254 | $340 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $153 | $166 | $180 |
| Office visit established patient minimal CPT 99211 • Office Visits | $23 | $23 | $23 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $57 | $99 | $141 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $91 | $159 | $228 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $128 | $187 | $247 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $143 | $299 | $455 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $82 | $147 | $212 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $129 | $264 | $333 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $171 | $171 | $171 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $49 | $85 | $126 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $78 | $78 | $78 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $117 | $117 | $117 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $80 | $142 | $205 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $113 | $113 | $113 |
| Consultation office low complexity CPT 99243 • Office Visits | $112 | $112 | $112 |
| Consultation office high complexity CPT 99245 • Office Visits | $209 | $209 | $209 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $1,525 | $1,525 | $1,525 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $38 | $38 | $38 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,165 | $1,165 | $1,165 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $203 | $203 | $203 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,083 | $1,083 | $1,083 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $503 | $503 | $503 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $234 | $234 | $234 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $736 | $736 | $736 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $537 | $537 | $537 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $112 | $112 | $112 |