| Sacroiliac joint injection CPT 27096 • Pain Management | $79 | $193 | $279 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $109 | $297 | $438 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $80 | $218 | $514 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $101 | $261 | $429 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $425 | $2,235 | $3,565 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $41 | $96 | $152 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $28 | $58 | $86 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $114 | $287 | $412 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $45 | $101 | $170 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $93 | $207 | $302 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $51 | $119 | $156 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $128 | $192 | $272 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $183 | $541 | $733 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $58 | $297 | $576 |
| Unlisted nervous system procedure CPT 64999 • Pain Management | $0 | $0 | $0 |
| Cytopathology concentration technique CPT 88108 • Pathology | $7 | $65 | $117 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $17 | $70 | $127 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $13 | $26 | $43 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $6 | $17 | $42 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $15 | $27 | $49 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $16 | $25 | $44 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $14 | $34 | $59 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $6 | $29 | $56 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $7 | $42 | $71 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $29 | $69 | $122 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $23 | $312 | $480 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $149 | $385 | $718 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $24 | $105 | $186 |
| Special stain group II CPT 88313 • Pathology | $5 | $74 | $136 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $16 | $73 | $172 |
| Frozen section pathology each additional CPT 88332 • Pathology | $13 | $53 | $93 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $23 | $82 | $161 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $30 | $90 | $188 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $36 | $95 | $200 |
| Microdissection manual CPT 88381 • Pathology | $65 | $196 | $322 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $4 | $8 | $16 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $10 | $18 | $42 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $10 | $15 | $21 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $12 | $22 | $50 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $11 | $18 | $28 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $22 | $38 | $51 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $25 | $42 | $57 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $22 | $36 | $61 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $21 | $35 | $48 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $15 | $25 | $45 |
| Physical therapy evaluation low complexity CPT 97161 • Physical Therapy | $77 | $130 | $175 |
| Physical therapy evaluation moderate complexity CPT 97162 • Physical Therapy | $77 | $127 | $175 |
| Physical therapy evaluation high complexity CPT 97163 • Physical Therapy | $75 | $122 | $175 |
| Physical therapy re-evaluation CPT 97164 • Physical Therapy | $52 | $78 | $103 |
| Therapeutic activities each 15 minutes CPT 97530 • Physical Therapy | $27 | $45 | $61 |