| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $281 | $344 | $469 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $170 | $171 | $171 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $278 | $369 | $460 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $30 | $1,264 | $2,499 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $152 | $152 | $152 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $53 | $60 | $68 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $30 | $222 | $415 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $30 | $66 | $102 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $192 | $259 | $327 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $59 | $107 | $166 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $166 | $203 | $240 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $460 | $568 | $784 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $189 | $233 | $322 |
| Cytopathology concentration technique CPT 88108 • Pathology | $23 | $37 | $51 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $57 | $59 | $62 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $27 | $29 | $31 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $12 | $13 | $14 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $25 | $30 | $35 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $4 | $15 | $20 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $28 | $29 | $31 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $26 | $28 | $30 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $32 | $33 | $34 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $32 | $45 | $59 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $206 | $222 | $230 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $349 | $395 | $441 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $27 | $56 | $85 |
| Special stain group II CPT 88313 • Pathology | $12 | $29 | $61 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $36 | $46 | $55 |
| Frozen section pathology each additional CPT 88332 • Pathology | $31 | $38 | $45 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $64 | $72 | $79 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $50 | $71 | $91 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $37 | $46 | $55 |
| Microdissection manual CPT 88381 • Pathology | $92 | $111 | $131 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $4 | $6 | $11 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $9 | $19 | $29 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $8 | $22 | $35 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $9 | $22 | $35 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $9 | $16 | $24 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $20 | $40 | $60 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $22 | $42 | $62 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $19 | $36 | $53 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $18 | $37 | $55 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $12 | $22 | $32 |
| Physical therapy evaluation low complexity CPT 97161 • Physical Therapy | $55 | $102 | $149 |
| Physical therapy evaluation moderate complexity CPT 97162 • Physical Therapy | $55 | $102 | $149 |
| Physical therapy evaluation high complexity CPT 97163 • Physical Therapy | $55 | $102 | $149 |
| Physical therapy re-evaluation CPT 97164 • Physical Therapy | $37 | $59 | $101 |
| Therapeutic activities each 15 minutes CPT 97530 • Physical Therapy | $26 | $45 | $64 |
| Self-care/home management training each 15 min CPT 97535 • Physical Therapy | $22 | $43 | $64 |
| Wheelchair management training each 15 minutes CPT 97542 • Physical Therapy | $21 | $33 | $57 |