| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $486 | $3,326 | $7,260 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $104 | $125 | $136 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $65 | $112 | $160 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $340 | $591 | $790 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $57 | $187 | $355 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $245 | $272 | $292 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $124 | $170 | $222 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $200 | $311 | $485 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $598 | $900 | $1,402 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $287 | $458 | $765 |
| Cytopathology concentration technique CPT 88108 • Pathology | $40 | $64 | $109 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $37 | $50 | $64 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $22 | $30 | $38 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $17 | $24 | $30 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $27 | $36 | $45 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $21 | $29 | $36 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $31 | $46 | $54 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $12 | $23 | $31 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $20 | $39 | $68 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $36 | $56 | $87 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $79 | $239 | $456 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $139 | $362 | $687 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $48 | $111 | $178 |
| Special stain group II CPT 88313 • Pathology | $12 | $54 | $130 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $39 | $82 | $110 |
| Frozen section pathology each additional CPT 88332 • Pathology | $23 | $55 | $87 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $55 | $104 | $144 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $95 | $120 | $168 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $95 | $111 | $125 |
| Microdissection manual CPT 88381 • Pathology | $45 | $176 | $316 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $19 | $19 | $19 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $38 | $38 | $38 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $36 | $36 | $36 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $33 | $38 | $44 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $22 | $33 | $44 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $36 | $63 | $90 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $104 | $104 | $104 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $90 | $90 | $90 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $30 | $57 | $83 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $55 | $55 | $55 |
| Physical therapy evaluation low complexity CPT 97161 • Physical Therapy | $81 | $195 | $308 |
| Physical therapy evaluation moderate complexity CPT 97162 • Physical Therapy | $82 | $160 | $308 |
| Physical therapy evaluation high complexity CPT 97163 • Physical Therapy | $83 | $196 | $308 |
| Physical therapy re-evaluation CPT 97164 • Physical Therapy | $82 | $125 | $213 |
| Therapeutic activities each 15 minutes CPT 97530 • Physical Therapy | $39 | $78 | $113 |
| Self-care/home management training each 15 min CPT 97535 • Physical Therapy | $81 | $91 | $100 |
| Wheelchair management training each 15 minutes CPT 97542 • Physical Therapy | $81 | $87 | $98 |
| Physical performance test each 15 minutes CPT 97750 • Physical Therapy | $81 | $92 | $103 |
| Orthotic management and training each 15 min CPT 97760 • Physical Therapy | $83 | $115 | $147 |
| Prosthetic training each 15 minutes CPT 97761 • Physical Therapy | $81 | $97 | $127 |