| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $70 | $100 | $116 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $123 | $140 | $157 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $108 | $122 | $144 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $168 | $172 | $176 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $71 | $85 | $96 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $79 | $126 | $150 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $98 | $133 | $150 |
| Group psychotherapy CPT 90853 • Mental Health | $26 | $52 | $77 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $4 | $5 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $135 | $135 | $135 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $30 | $82 | $133 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $102 | $118 | $134 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $48 | $207 | $367 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $48 | $48 | $48 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $75 | $93 | $111 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $103 | $142 | $161 |
| EMG needle each extremity complete CPT 95886 • Neurology | $39 | $39 | $39 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $42 | $66 | $90 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $22 | $70 | $117 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $78 | $118 | $141 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $107 | $141 | $175 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $285 | $295 | $305 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $56 | $66 | $71 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $82 | $96 | $109 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $126 | $145 | $164 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $130 | $187 | $216 |
| Office visit established patient minimal CPT 99211 • Office Visits | $8 | $23 | $30 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $34 | $48 | $57 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $30 | $57 | $88 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $30 | $79 | $125 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $111 | $143 | $176 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $30 | $93 | $170 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $108 | $139 | $170 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $159 | $185 | $198 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $33 | $81 | $129 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $30 | $72 | $129 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $30 | $81 | $129 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $30 | $73 | $129 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $85 | $108 | $130 |
| Consultation office low complexity CPT 99243 • Office Visits | $30 | $69 | $92 |
| Consultation office high complexity CPT 99245 • Office Visits | $201 | $228 | $255 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $525 | $525 | $525 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $53 | $53 | $53 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $956 | $1,043 | $1,130 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $259 | $259 | $259 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $30 | $453 | $875 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $465 | $474 | $483 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $302 | $302 | $302 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $801 | $801 | $801 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $30 | $300 | $570 |