| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $383 | $1,094 | $2,232 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $41 | $105 | $140 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $54 | $78 | $102 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $177 | $584 | $790 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $48 | $134 | $205 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $292 | $398 | $561 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $105 | $177 | $279 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $247 | $318 | $433 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $798 | $1,093 | $1,377 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $287 | $442 | $612 |
| Cytopathology concentration technique CPT 88108 • Pathology | $40 | $109 | $205 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $49 | $103 | $194 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $39 | $55 | $70 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $34 | $41 | $48 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $27 | $48 | $69 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $4 | $23 | $39 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $27 | $39 | $54 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $12 | $51 | $97 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $20 | $65 | $123 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $49 | $68 | $87 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $183 | $429 | $832 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $260 | $654 | $1,234 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $41 | $139 | $329 |
| Special stain group II CPT 88313 • Pathology | $21 | $134 | $245 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $68 | $87 | $110 |
| Frozen section pathology each additional CPT 88332 • Pathology | $52 | $88 | $156 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $112 | $185 | $282 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $97 | $186 | $330 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $90 | $145 | $249 |
| Microdissection manual CPT 88381 • Pathology | $45 | $297 | $569 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $4 | $12 | $19 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $14 | $14 | $14 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $9 | $11 | $13 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $12 | $24 | $33 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $22 | $29 | $41 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $30 | $50 | $83 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $22 | $28 | $34 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $19 | $35 | $51 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $14 | $31 | $49 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $18 | $35 | $51 |
| Physical therapy evaluation low complexity CPT 97161 • Physical Therapy | $172 | $227 | $282 |
| Physical therapy evaluation moderate complexity CPT 97162 • Physical Therapy | $166 | $169 | $172 |
| Physical therapy evaluation high complexity CPT 97163 • Physical Therapy | $172 | $227 | $282 |
| Physical therapy re-evaluation CPT 97164 • Physical Therapy | $40 | $69 | $118 |
| Therapeutic activities each 15 minutes CPT 97530 • Physical Therapy | $23 | $41 | $61 |
| Self-care/home management training each 15 min CPT 97535 • Physical Therapy | $57 | $75 | $94 |
| Wheelchair management training each 15 minutes CPT 97542 • Physical Therapy | $21 | $49 | $89 |
| Physical performance test each 15 minutes CPT 97750 • Physical Therapy | $38 | $68 | $98 |
| Orthotic management and training each 15 min CPT 97760 • Physical Therapy | $80 | $108 | $135 |
| Prosthetic training each 15 minutes CPT 97761 • Physical Therapy | $70 | $94 | $118 |