| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $126 | $192 | $258 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $27 | $64 | $101 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $9 | $145 | $282 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $30 | $30 | $30 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $56 | $66 | $76 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $53 | $54 | $54 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $16 | $134 | $252 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $38 | $43 | $48 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $197 | $198 | $198 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $89 | $94 | $99 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $89 | $132 | $175 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $38 | $258 | $479 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $6 | $109 | $212 |
| Cytopathology concentration technique CPT 88108 • Pathology | $10 | $27 | $45 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $26 | $35 | $45 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $5 | $12 | $20 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $7 | $13 | $18 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $11 | $14 | $18 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $3 | $3 | $3 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $19 | $22 | $26 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $19 | $19 | $20 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $29 | $46 | $64 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $44 | $44 | $45 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $64 | $130 | $195 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $67 | $181 | $296 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $43 | $52 | $61 |
| Special stain group II CPT 88313 • Pathology | $43 | $70 | $96 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $39 | $76 | $113 |
| Frozen section pathology each additional CPT 88332 • Pathology | $6 | $19 | $31 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $11 | $34 | $56 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $13 | $40 | $67 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $41 | $51 | $60 |
| Microdissection manual CPT 88381 • Pathology | $74 | $117 | $160 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $5 | $5 | $5 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $9 | $12 | $15 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $10 | $10 | $11 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $18 | $18 | $18 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $7 | $9 | $12 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $20 | $22 | $25 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $23 | $23 | $23 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $16 | $20 | $25 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $18 | $20 | $23 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $12 | $13 | $15 |
| Physical therapy evaluation low complexity CPT 97161 • Physical Therapy | $49 | $58 | $66 |
| Physical therapy evaluation moderate complexity CPT 97162 • Physical Therapy | $66 | $66 | $66 |
| Physical therapy evaluation high complexity CPT 97163 • Physical Therapy | $49 | $67 | $85 |
| Physical therapy re-evaluation CPT 97164 • Physical Therapy | $29 | $43 | $57 |
| Therapeutic activities each 15 minutes CPT 97530 • Physical Therapy | $21 | $23 | $26 |
| Self-care/home management training each 15 min CPT 97535 • Physical Therapy | $21 | $24 | $27 |
| Wheelchair management training each 15 minutes CPT 97542 • Physical Therapy | $18 | $19 | $20 |