| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $94 | $143 | $209 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $128 | $226 | $391 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $166 | $203 | $277 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $200 | $258 | $375 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $72 | $118 | $185 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $154 | $188 | $255 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $121 | $182 | $266 |
| Group psychotherapy CPT 90853 • Mental Health | $37 | $50 | $71 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $3 | $7 | $12 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $16 | $156 | $344 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $14 | $160 | $306 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $22 | $167 | $352 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $186 | $464 | $834 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $85 | $549 | $1,137 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $50 | $155 | $291 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $174 | $184 | $206 |
| EMG needle each extremity complete CPT 95886 • Neurology | $44 | $129 | $253 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $96 | $110 | $137 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $119 | $123 | $125 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $77 | $144 | $206 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $196 | $222 | $274 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $292 | $444 | $747 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $11 | $68 | $113 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $11 | $122 | $216 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $172 | $214 | $259 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $30 | $207 | $351 |
| Office visit established patient minimal CPT 99211 • Office Visits | $17 | $26 | $34 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $2 | $53 | $109 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $49 | $89 | $128 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $76 | $147 | $247 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $54 | $168 | $278 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $15 | $114 | $161 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $33 | $166 | $253 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $209 | $267 | $338 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $44 | $70 | $96 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $10 | $88 | $154 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $10 | $127 | $232 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $80 | $110 | $157 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $52 | $138 | $222 |
| Consultation office low complexity CPT 99243 • Office Visits | $9 | $115 | $220 |
| Consultation office high complexity CPT 99245 • Office Visits | $245 | $308 | $353 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $234 | $772 | $1,614 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $26 | $63 | $94 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $885 | $1,964 | $3,043 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $239 | $437 | $635 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $241 | $1,422 | $2,818 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $645 | $864 | $1,301 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $226 | $417 | $609 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $595 | $1,258 | $1,922 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $448 | $926 | $1,403 |