| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $221 | $1,280 | $2,232 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $7 | $131 | $250 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $37 | $102 | $167 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $89 | $697 | $1,184 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $9 | $110 | $173 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $72 | $316 | $586 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $70 | $173 | $302 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $103 | $286 | $508 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $449 | $597 | $701 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $38 | $174 | $287 |
| Cytopathology concentration technique CPT 88108 • Pathology | $13 | $75 | $171 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $25 | $82 | $173 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $5 | $32 | $60 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $5 | $26 | $47 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $5 | $39 | $72 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $4 | $31 | $58 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $5 | $48 | $85 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $5 | $12 | $18 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $18 | $39 | $80 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $29 | $100 | $185 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $121 | $350 | $746 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $254 | $422 | $752 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $15 | $44 | $69 |
| Special stain group II CPT 88313 • Pathology | $21 | $27 | $31 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $16 | $77 | $110 |
| Frozen section pathology each additional CPT 88332 • Pathology | $17 | $50 | $80 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $53 | $105 | $149 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $71 | $86 | $97 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $95 | $103 | $109 |
| Microdissection manual CPT 88381 • Pathology | $19 | $42 | $62 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $5 | $9 | $14 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $12 | $20 | $27 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $15 | $20 | $26 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $14 | $26 | $33 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $9 | $21 | $32 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $24 | $42 | $65 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $25 | $50 | $75 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $21 | $43 | $65 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $22 | $38 | $60 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $13 | $26 | $39 |
| Physical therapy evaluation low complexity CPT 97161 • Physical Therapy | $61 | $142 | $223 |
| Physical therapy evaluation moderate complexity CPT 97162 • Physical Therapy | $61 | $150 | $223 |
| Physical therapy evaluation high complexity CPT 97163 • Physical Therapy | $30 | $127 | $223 |
| Physical therapy re-evaluation CPT 97164 • Physical Therapy | $21 | $87 | $154 |
| Therapeutic activities each 15 minutes CPT 97530 • Physical Therapy | $26 | $49 | $82 |
| Self-care/home management training each 15 min CPT 97535 • Physical Therapy | $26 | $49 | $73 |
| Wheelchair management training each 15 minutes CPT 97542 • Physical Therapy | $23 | $47 | $71 |
| Physical performance test each 15 minutes CPT 97750 • Physical Therapy | $25 | $50 | $75 |
| Orthotic management and training each 15 min CPT 97760 • Physical Therapy | $29 | $68 | $106 |
| Prosthetic training each 15 minutes CPT 97761 • Physical Therapy | $25 | $58 | $92 |