| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $141 | $297 | $449 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $307 | $1,288 | $2,232 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $39 | $88 | $136 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $53 | $72 | $108 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $189 | $469 | $790 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $42 | $149 | $355 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $149 | $297 | $551 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $99 | $159 | $288 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $115 | $231 | $386 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $360 | $735 | $1,402 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $20 | $285 | $765 |
| Cytopathology concentration technique CPT 88108 • Pathology | $23 | $37 | $45 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $26 | $37 | $49 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $20 | $21 | $22 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $4 | $9 | $17 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $18 | $21 | $27 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $7 | $14 | $21 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $19 | $31 | $54 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $12 | $20 | $31 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $6 | $16 | $29 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $9 | $44 | $87 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $79 | $139 | $195 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $139 | $248 | $297 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $48 | $63 | $81 |
| Special stain group II CPT 88313 • Pathology | $8 | $21 | $43 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $30 | $67 | $110 |
| Frozen section pathology each additional CPT 88332 • Pathology | $6 | $29 | $55 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $27 | $44 | $56 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $67 | $82 | $97 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $33 | $69 | $113 |
| Microdissection manual CPT 88381 • Pathology | $23 | $50 | $74 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $3 | $9 | $19 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $9 | $19 | $38 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $11 | $20 | $36 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $11 | $25 | $44 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $7 | $20 | $44 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $19 | $41 | $90 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $20 | $48 | $104 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $16 | $41 | $90 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $17 | $37 | $83 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $10 | $25 | $55 |
| Physical therapy evaluation low complexity CPT 97161 • Physical Therapy | $49 | $135 | $308 |
| Physical therapy evaluation moderate complexity CPT 97162 • Physical Therapy | $49 | $151 | $308 |
| Physical therapy evaluation high complexity CPT 97163 • Physical Therapy | $25 | $166 | $308 |
| Physical therapy re-evaluation CPT 97164 • Physical Therapy | $17 | $104 | $213 |
| Therapeutic activities each 15 minutes CPT 97530 • Physical Therapy | $39 | $79 | $113 |
| Self-care/home management training each 15 min CPT 97535 • Physical Therapy | $21 | $68 | $100 |
| Wheelchair management training each 15 minutes CPT 97542 • Physical Therapy | $18 | $65 | $98 |
| Physical performance test each 15 minutes CPT 97750 • Physical Therapy | $19 | $68 | $103 |
| Orthotic management and training each 15 min CPT 97760 • Physical Therapy | $22 | $84 | $147 |