| Peripheral nerve block injection CPT 64450 • Pain Management | $35 | $129 | $223 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $141 | $145 | $149 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $303 | $499 | $696 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $124 | $226 | $328 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $278 | $390 | $501 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $256 | $264 | $273 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $186 | $303 | $420 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $1,167 | $1,207 | $1,247 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $77 | $120 | $162 |
| Cytopathology concentration technique CPT 88108 • Pathology | $14 | $104 | $195 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $27 | $110 | $193 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $16 | $42 | $68 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $15 | $19 | $23 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $27 | $30 | $33 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $13 | $20 | $27 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $21 | $58 | $95 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $33 | $64 | $94 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $30 | $76 | $122 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $19 | $61 | $103 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $389 | $603 | $817 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $257 | $742 | $1,228 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $48 | $184 | $320 |
| Special stain group II CPT 88313 • Pathology | $89 | $162 | $235 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $46 | $81 | $117 |
| Frozen section pathology each additional CPT 88332 • Pathology | $33 | $94 | $154 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $18 | $138 | $258 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $25 | $163 | $301 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $83 | $155 | $227 |
| Microdissection manual CPT 88381 • Pathology | $157 | $364 | $570 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $5 | $11 | $18 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $35 | $38 | $42 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $13 | $23 | $33 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $41 | $42 | $43 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $15 | $18 | $21 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $43 | $64 | $86 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $29 | $62 | $96 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $83 | $86 | $88 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $29 | $53 | $77 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $19 | $35 | $51 |
| Physical therapy evaluation low complexity CPT 97161 • Physical Therapy | $88 | $116 | $143 |
| Physical therapy evaluation moderate complexity CPT 97162 • Physical Therapy | $241 | $263 | $285 |
| Physical therapy evaluation high complexity CPT 97163 • Physical Therapy | $82 | $184 | $285 |
| Physical therapy re-evaluation CPT 97164 • Physical Therapy | $56 | $127 | $198 |
| Therapeutic activities each 15 minutes CPT 97530 • Physical Therapy | $107 | $109 | $110 |
| Self-care/home management training each 15 min CPT 97535 • Physical Therapy | $89 | $91 | $93 |
| Wheelchair management training each 15 minutes CPT 97542 • Physical Therapy | $34 | $62 | $90 |
| Physical performance test each 15 minutes CPT 97750 • Physical Therapy | $97 | $99 | $101 |
| Orthotic management and training each 15 min CPT 97760 • Physical Therapy | $51 | $93 | $136 |
| Prosthetic training each 15 minutes CPT 97761 • Physical Therapy | $28 | $74 | $119 |
| Immunization admin first vaccine component CPT 90460 • Preventive Care | $41 | $52 | $65 |