| Peripheral nerve block injection CPT 64450 • Pain Management | $50 | $78 | $105 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $63 | $96 | $128 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $644 | $675 | $705 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $106 | $107 | $107 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $118 | $311 | $505 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $107 | $182 | $251 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $225 | $311 | $398 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $689 | $924 | $1,238 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $95 | $248 | $360 |
| Cytopathology concentration technique CPT 88108 • Pathology | $5 | $95 | $184 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $125 | $149 | $174 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $23 | $31 | $38 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $11 | $11 | $11 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $37 | $37 | $37 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $37 | $37 | $37 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $33 | $33 | $33 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $17 | $52 | $87 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $26 | $68 | $110 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $42 | $43 | $45 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $95 | $530 | $747 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $127 | $617 | $1,107 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $22 | $127 | $233 |
| Special stain group II CPT 88313 • Pathology | $14 | $106 | $220 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $70 | $89 | $109 |
| Frozen section pathology each additional CPT 88332 • Pathology | $35 | $88 | $140 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $72 | $163 | $253 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $45 | $170 | $296 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $111 | $216 | $322 |
| Microdissection manual CPT 88381 • Pathology | $213 | $213 | $213 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $5 | $6 | $7 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $16 | $17 | $19 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $16 | $19 | $23 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $18 | $18 | $18 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $13 | $25 | $37 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $31 | $53 | $75 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $32 | $58 | $84 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $27 | $51 | $75 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $29 | $50 | $71 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $20 | $20 | $20 |
| Physical therapy evaluation low complexity CPT 97161 • Physical Therapy | $94 | $173 | $252 |
| Physical therapy evaluation moderate complexity CPT 97162 • Physical Therapy | $94 | $173 | $252 |
| Physical therapy evaluation high complexity CPT 97163 • Physical Therapy | $94 | $94 | $94 |
| Physical therapy re-evaluation CPT 97164 • Physical Therapy | $64 | $101 | $175 |
| Therapeutic activities each 15 minutes CPT 97530 • Physical Therapy | $32 | $36 | $41 |
| Self-care/home management training each 15 min CPT 97535 • Physical Therapy | $34 | $34 | $34 |
| Wheelchair management training each 15 minutes CPT 97542 • Physical Therapy | $31 | $31 | $31 |
| Physical performance test each 15 minutes CPT 97750 • Physical Therapy | $32 | $32 | $32 |
| Orthotic management and training each 15 min CPT 97760 • Physical Therapy | $34 | $39 | $44 |
| Prosthetic training each 15 minutes CPT 97761 • Physical Therapy | $31 | $31 | $31 |
| Immunization admin first vaccine component CPT 90460 • Preventive Care | $15 | $20 | $30 |