| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $1,554 | $7,784 | $14,015 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $42 | $101 | $161 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $53 | $116 | $179 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $252 | $572 | $892 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $42 | $118 | $193 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $198 | $266 | $334 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $59 | $164 | $332 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $175 | $385 | $596 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $479 | $1,684 | $3,013 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $68 | $655 | $1,250 |
| Cytopathology concentration technique CPT 88108 • Pathology | $45 | $96 | $147 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $45 | $102 | $159 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $20 | $40 | $61 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $7 | $19 | $30 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $18 | $36 | $53 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $27 | $35 | $43 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $79 | $79 | $79 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $16 | $18 | $20 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $27 | $28 | $29 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $45 | $61 | $77 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $192 | $405 | $829 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $296 | $317 | $338 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $61 | $61 | $61 |
| Special stain group II CPT 88313 • Pathology | $28 | $36 | $43 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $145 | $216 | $288 |
| Frozen section pathology each additional CPT 88332 • Pathology | $31 | $79 | $127 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $56 | $138 | $219 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $67 | $118 | $168 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $75 | $185 | $296 |
| Microdissection manual CPT 88381 • Pathology | $74 | $253 | $432 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $21 | $24 | $26 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $47 | $52 | $57 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $11 | $26 | $40 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $48 | $53 | $58 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $7 | $27 | $47 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $19 | $59 | $100 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $115 | $127 | $139 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $16 | $57 | $98 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $92 | $101 | $111 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $10 | $35 | $59 |
| Physical therapy evaluation low complexity CPT 97161 • Physical Therapy | $49 | $164 | $279 |
| Physical therapy evaluation moderate complexity CPT 97162 • Physical Therapy | $279 | $279 | $279 |
| Physical therapy evaluation high complexity CPT 97163 • Physical Therapy | $279 | $279 | $279 |
| Physical therapy re-evaluation CPT 97164 • Physical Therapy | $33 | $153 | $233 |
| Therapeutic activities each 15 minutes CPT 97530 • Physical Therapy | $130 | $143 | $157 |
| Self-care/home management training each 15 min CPT 97535 • Physical Therapy | $21 | $66 | $112 |
| Wheelchair management training each 15 minutes CPT 97542 • Physical Therapy | $18 | $85 | $130 |
| Physical performance test each 15 minutes CPT 97750 • Physical Therapy | $19 | $67 | $114 |
| Orthotic management and training each 15 min CPT 97760 • Physical Therapy | $163 | $180 | $197 |
| Prosthetic training each 15 minutes CPT 97761 • Physical Therapy | $19 | $78 | $138 |