| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $2,288 | $4,460 | $6,247 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $15 | $171 | $293 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $49 | $121 | $178 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $672 | $739 | $807 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $110 | $204 | $306 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $482 | $558 | $635 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $89 | $219 | $320 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $150 | $365 | $528 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $437 | $1,060 | $1,538 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $228 | $375 | $658 |
| Cytopathology concentration technique CPT 88108 • Pathology | $49 | $119 | $189 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $112 | $112 | $112 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $66 | $66 | $66 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $13 | $32 | $52 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $21 | $51 | $80 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $9 | $36 | $64 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $94 | $94 | $94 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $93 | $93 | $93 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $121 | $121 | $121 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $107 | $107 | $107 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $219 | $522 | $826 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $417 | $417 | $417 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $320 | $320 | $320 |
| Special stain group II CPT 88313 • Pathology | $62 | $147 | $232 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $79 | $98 | $116 |
| Frozen section pathology each additional CPT 88332 • Pathology | $88 | $88 | $88 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $68 | $157 | $247 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $77 | $132 | $186 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $32 | $125 | $218 |
| Microdissection manual CPT 88381 • Pathology | $503 | $503 | $503 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $5 | $9 | $12 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $10 | $17 | $24 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $10 | $16 | $23 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $12 | $20 | $28 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $12 | $20 | $28 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $57 | $57 | $57 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $66 | $66 | $66 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $25 | $41 | $57 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $53 | $53 | $53 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $35 | $35 | $35 |
| Physical therapy evaluation low complexity CPT 97161 • Physical Therapy | $196 | $196 | $196 |
| Physical therapy evaluation moderate complexity CPT 97162 • Physical Therapy | $84 | $140 | $196 |
| Physical therapy evaluation high complexity CPT 97163 • Physical Therapy | $196 | $196 | $196 |
| Physical therapy re-evaluation CPT 97164 • Physical Therapy | $58 | $96 | $135 |
| Therapeutic activities each 15 minutes CPT 97530 • Physical Therapy | $72 | $72 | $72 |
| Self-care/home management training each 15 min CPT 97535 • Physical Therapy | $64 | $64 | $64 |
| Wheelchair management training each 15 minutes CPT 97542 • Physical Therapy | $27 | $44 | $62 |
| Physical performance test each 15 minutes CPT 97750 • Physical Therapy | $66 | $66 | $66 |
| Orthotic management and training each 15 min CPT 97760 • Physical Therapy | $93 | $93 | $93 |
| Prosthetic training each 15 minutes CPT 97761 • Physical Therapy | $35 | $58 | $81 |