| Sacroiliac joint injection CPT 27096 • Pain Management | $83 | $202 | $374 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $129 | $313 | $440 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $103 | $230 | $363 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $98 | $320 | $520 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $550 | $1,534 | $3,428 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $73 | $120 | $158 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $32 | $61 | $86 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $92 | $319 | $476 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $27 | $179 | $305 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $100 | $267 | $410 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $42 | $111 | $159 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $119 | $228 | $390 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $260 | $550 | $817 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $69 | $250 | $395 |
| Unlisted nervous system procedure CPT 64999 • Pain Management | $0 | $0 | $0 |
| Cytopathology concentration technique CPT 88108 • Pathology | $8 | $49 | $117 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $19 | $85 | $149 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $13 | $29 | $41 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $6 | $17 | $26 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $15 | $51 | $64 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $17 | $27 | $38 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $14 | $32 | $45 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $23 | $56 | $80 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $19 | $49 | $99 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $31 | $81 | $154 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $44 | $239 | $332 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $131 | $326 | $498 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $4 | $94 | $154 |
| Special stain group II CPT 88313 • Pathology | $3 | $50 | $112 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $6 | $77 | $134 |
| Frozen section pathology each additional CPT 88332 • Pathology | $16 | $44 | $65 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $37 | $70 | $79 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $40 | $90 | $151 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $20 | $103 | $190 |
| Microdissection manual CPT 88381 • Pathology | $52 | $208 | $348 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $4 | $6 | $8 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $10 | $14 | $16 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $10 | $18 | $25 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $10 | $17 | $22 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $9 | $15 | $17 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $22 | $38 | $45 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $22 | $38 | $47 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $17 | $33 | $40 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $21 | $34 | $42 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $14 | $21 | $29 |
| Physical therapy evaluation low complexity CPT 97161 • Physical Therapy | $58 | $101 | $144 |
| Physical therapy evaluation moderate complexity CPT 97162 • Physical Therapy | $58 | $99 | $144 |
| Physical therapy evaluation high complexity CPT 97163 • Physical Therapy | $75 | $108 | $144 |
| Physical therapy re-evaluation CPT 97164 • Physical Therapy | $28 | $83 | $128 |
| Therapeutic activities each 15 minutes CPT 97530 • Physical Therapy | $18 | $38 | $48 |