| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $1,563 | $3,837 | $6,112 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $201 | $237 | $273 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $134 | $156 | $178 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $298 | $552 | $807 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $184 | $242 | $299 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $471 | $553 | $635 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $44 | $202 | $320 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $325 | $426 | $528 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $399 | $817 | $1,538 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $51 | $428 | $644 |
| Cytopathology concentration technique CPT 88108 • Pathology | $72 | $72 | $72 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $30 | $30 | $30 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $14 | $19 | $25 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $20 | $20 | $20 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $16 | $23 | $31 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $25 | $25 | $25 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $36 | $36 | $36 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $20 | $28 | $36 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $26 | $30 | $34 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $21 | $29 | $38 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $91 | $91 | $91 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $478 | $478 | $478 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $29 | $50 | $70 |
| Special stain group II CPT 88313 • Pathology | $50 | $59 | $75 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $63 | $66 | $68 |
| Frozen section pathology each additional CPT 88332 • Pathology | $60 | $60 | $60 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $31 | $43 | $55 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $63 | $86 | $110 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $50 | $90 | $129 |
| Microdissection manual CPT 88381 • Pathology | $26 | $26 | $26 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $3 | $8 | $17 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $6 | $20 | $33 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $6 | $19 | $32 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $7 | $23 | $39 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $7 | $23 | $39 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $14 | $47 | $80 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $16 | $54 | $91 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $14 | $47 | $80 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $13 | $43 | $74 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $8 | $28 | $48 |
| Physical therapy evaluation low complexity CPT 97161 • Physical Therapy | $48 | $160 | $272 |
| Physical therapy evaluation moderate complexity CPT 97162 • Physical Therapy | $48 | $160 | $272 |
| Physical therapy evaluation high complexity CPT 97163 • Physical Therapy | $48 | $160 | $272 |
| Physical therapy re-evaluation CPT 97164 • Physical Therapy | $33 | $84 | $188 |
| Therapeutic activities each 15 minutes CPT 97530 • Physical Therapy | $18 | $59 | $100 |
| Self-care/home management training each 15 min CPT 97535 • Physical Therapy | $16 | $52 | $89 |
| Wheelchair management training each 15 minutes CPT 97542 • Physical Therapy | $86 | $86 | $86 |
| Physical performance test each 15 minutes CPT 97750 • Physical Therapy | $16 | $54 | $91 |
| Orthotic management and training each 15 min CPT 97760 • Physical Therapy | $23 | $77 | $130 |
| Prosthetic training each 15 minutes CPT 97761 • Physical Therapy | $112 | $112 | $112 |