| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $725 | $973 | $1,222 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $108 | $120 | $133 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $87 | $95 | $102 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $144 | $286 | $427 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $89 | $199 | $309 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $264 | $285 | $306 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $158 | $204 | $250 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $266 | $315 | $364 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $706 | $894 | $1,209 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $219 | $312 | $418 |
| Cytopathology concentration technique CPT 88108 • Pathology | $23 | $109 | $195 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $29 | $111 | $193 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $36 | $52 | $68 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $21 | $22 | $23 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $33 | $35 | $37 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $19 | $37 | $55 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $35 | $63 | $92 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $31 | $63 | $94 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $18 | $70 | $122 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $32 | $67 | $101 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $169 | $461 | $817 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $187 | $708 | $1,228 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $59 | $189 | $320 |
| Special stain group II CPT 88313 • Pathology | $7 | $121 | $235 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $36 | $97 | $159 |
| Frozen section pathology each additional CPT 88332 • Pathology | $32 | $93 | $154 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $57 | $157 | $258 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $37 | $169 | $301 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $44 | $193 | $342 |
| Microdissection manual CPT 88381 • Pathology | $157 | $364 | $570 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $17 | $17 | $18 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $33 | $35 | $38 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $33 | $34 | $36 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $16 | $27 | $38 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $21 | $31 | $40 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $43 | $66 | $89 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $96 | $98 | $100 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $25 | $52 | $79 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $77 | $79 | $82 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $48 | $49 | $51 |
| Physical therapy evaluation low complexity CPT 97161 • Physical Therapy | $82 | $113 | $143 |
| Physical therapy evaluation moderate complexity CPT 97162 • Physical Therapy | $239 | $262 | $285 |
| Physical therapy evaluation high complexity CPT 97163 • Physical Therapy | $82 | $176 | $271 |
| Physical therapy re-evaluation CPT 97164 • Physical Therapy | $83 | $148 | $198 |
| Therapeutic activities each 15 minutes CPT 97530 • Physical Therapy | $102 | $102 | $103 |
| Self-care/home management training each 15 min CPT 97535 • Physical Therapy | $93 | $96 | $99 |
| Wheelchair management training each 15 minutes CPT 97542 • Physical Therapy | $90 | $91 | $93 |
| Physical performance test each 15 minutes CPT 97750 • Physical Therapy | $91 | $94 | $97 |
| Orthotic management and training each 15 min CPT 97760 • Physical Therapy | $136 | $139 | $143 |
| Prosthetic training each 15 minutes CPT 97761 • Physical Therapy | $117 | $118 | $119 |