| Psychotherapy 60 minutes CPT 90837 • Mental Health | $102 | $185 | $322 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $151 | $229 | $278 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $298 | $317 | $336 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $48 | $119 | $162 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $67 | $163 | $263 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $110 | $225 | $271 |
| Group psychotherapy CPT 90853 • Mental Health | $18 | $37 | $67 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $6 | $9 | $13 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $70 | $228 | $511 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $111 | $243 | $436 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $107 | $258 | $390 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $80 | $380 | $706 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $80 | $438 | $826 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $102 | $168 | $296 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $143 | $165 | $208 |
| EMG needle each extremity complete CPT 95886 • Neurology | $92 | $149 | $224 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $85 | $92 | $99 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $103 | $135 | $167 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $128 | $157 | $197 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $167 | $293 | $454 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $275 | $480 | $753 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $60 | $102 | $144 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $88 | $131 | $210 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $116 | $199 | $258 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $159 | $241 | $334 |
| Office visit established patient minimal CPT 99211 • Office Visits | $18 | $23 | $31 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $47 | $64 | $84 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $70 | $83 | $101 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $17 | $77 | $156 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $152 | $210 | $281 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $71 | $149 | $200 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $112 | $191 | $272 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $150 | $233 | $401 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $43 | $63 | $78 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $68 | $112 | $143 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $103 | $150 | $205 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $69 | $104 | $143 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $98 | $138 | $211 |
| Consultation office low complexity CPT 99243 • Office Visits | $54 | $155 | $244 |
| Consultation office high complexity CPT 99245 • Office Visits | $30 | $245 | $445 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $507 | $1,012 | $1,518 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $39 | $133 | $226 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $3,851 | $3,851 | $3,851 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $1,118 | $1,118 | $1,118 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,112 | $2,533 | $3,954 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $511 | $1,034 | $2,076 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $302 | $636 | $970 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $2,661 | $2,661 | $2,661 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $729 | $1,432 | $2,135 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $334 | $334 | $334 |