| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $135 | $168 | $200 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $85 | $207 | $342 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $30 | $1,111 | $2,542 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $30 | $48 | $58 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $49 | $66 | $86 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $30 | $147 | $316 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $139 | $160 | $200 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $167 | $194 | $231 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $94 | $108 | $127 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $203 | $229 | $256 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $503 | $546 | $580 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $81 | $201 | $313 |
| Cytopathology concentration technique CPT 88108 • Pathology | $14 | $47 | $80 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $17 | $43 | $79 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $11 | $18 | $28 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $9 | $16 | $22 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $12 | $25 | $37 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $13 | $20 | $27 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $21 | $30 | $40 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $15 | $26 | $38 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $18 | $29 | $50 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $33 | $54 | $84 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $52 | $193 | $334 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $257 | $380 | $504 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $39 | $78 | $131 |
| Special stain group II CPT 88313 • Pathology | $8 | $45 | $96 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $47 | $54 | $60 |
| Frozen section pathology each additional CPT 88332 • Pathology | $19 | $42 | $64 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $44 | $69 | $106 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $42 | $72 | $123 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $48 | $49 | $50 |
| Microdissection manual CPT 88381 • Pathology | $110 | $171 | $232 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $6 | $6 | $6 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $10 | $13 | $16 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $8 | $11 | $16 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $14 | $14 | $14 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $11 | $15 | $19 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $20 | $29 | $39 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $23 | $33 | $45 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $20 | $28 | $39 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $19 | $27 | $36 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $14 | $18 | $24 |
| Physical therapy evaluation low complexity CPT 97161 • Physical Therapy | $75 | $79 | $84 |
| Physical therapy evaluation moderate complexity CPT 97162 • Physical Therapy | $76 | $106 | $135 |
| Physical therapy evaluation high complexity CPT 97163 • Physical Therapy | $76 | $77 | $79 |
| Physical therapy re-evaluation CPT 97164 • Physical Therapy | $52 | $64 | $93 |
| Therapeutic activities each 15 minutes CPT 97530 • Physical Therapy | $27 | $37 | $49 |
| Self-care/home management training each 15 min CPT 97535 • Physical Therapy | $22 | $27 | $32 |
| Wheelchair management training each 15 minutes CPT 97542 • Physical Therapy | $31 | $31 | $31 |
| Physical performance test each 15 minutes CPT 97750 • Physical Therapy | $32 | $32 | $32 |