| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $41 | $301 | $1,080 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $41 | $79 | $195 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $33 | $64 | $130 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $41 | $195 | $504 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $41 | $105 | $290 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $171 | $193 | $235 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $85 | $101 | $152 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $126 | $193 | $396 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $418 | $600 | $1,144 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $178 | $289 | $624 |
| Cytopathology concentration technique CPT 88108 • Pathology | $63 | $63 | $63 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $64 | $88 | $100 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $27 | $29 | $33 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $13 | $15 | $22 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $27 | $27 | $27 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $30 | $30 | $30 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $44 | $44 | $44 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $31 | $47 | $54 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $29 | $52 | $63 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $68 | $93 | $106 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $196 | $218 | $226 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $303 | $327 | $339 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $81 | $99 | $108 |
| Special stain group II CPT 88313 • Pathology | $66 | $73 | $79 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $33 | $59 | $88 |
| Frozen section pathology each additional CPT 88332 • Pathology | $53 | $53 | $53 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $65 | $74 | $100 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $95 | $101 | $103 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $40 | $89 | $122 |
| Microdissection manual CPT 88381 • Pathology | $190 | $190 | $190 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $4 | $5 | $6 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $14 | $16 | $20 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $13 | $17 | $28 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $13 | $16 | $23 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $8 | $14 | $18 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $12 | $22 | $41 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $14 | $37 | $82 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $14 | $21 | $36 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $13 | $33 | $66 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $14 | $24 | $43 |
| Physical therapy evaluation low complexity CPT 97161 • Physical Therapy | $58 | $120 | $245 |
| Physical therapy evaluation moderate complexity CPT 97162 • Physical Therapy | $58 | $74 | $122 |
| Physical therapy evaluation high complexity CPT 97163 • Physical Therapy | $58 | $120 | $245 |
| Physical therapy re-evaluation CPT 97164 • Physical Therapy | $40 | $72 | $169 |
| Therapeutic activities each 15 minutes CPT 97530 • Physical Therapy | $14 | $43 | $90 |
| Self-care/home management training each 15 min CPT 97535 • Physical Therapy | $14 | $24 | $43 |
| Wheelchair management training each 15 minutes CPT 97542 • Physical Therapy | $77 | $77 | $77 |
| Physical performance test each 15 minutes CPT 97750 • Physical Therapy | $42 | $42 | $42 |
| Orthotic management and training each 15 min CPT 97760 • Physical Therapy | $14 | $52 | $117 |
| Prosthetic training each 15 minutes CPT 97761 • Physical Therapy | $101 | $101 | $101 |