| Peripheral nerve block injection CPT 64450 • Pain Management | $97 | $225 | $443 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $65 | $81 | $112 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $259 | $586 | $990 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $114 | $255 | $443 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $351 | $367 | $392 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $121 | $155 | $198 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $199 | $207 | $213 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $318 | $666 | $951 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $68 | $234 | $328 |
| Unlisted nervous system procedure CPT 64999 • Pain Management | $3,285 | $3,285 | $3,285 |
| Cytopathology concentration technique CPT 88108 • Pathology | $50 | $50 | $50 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $60 | $60 | $60 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $16 | $16 | $16 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $21 | $21 | $21 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $23 | $40 | $58 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $19 | $19 | $19 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $17 | $17 | $17 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $25 | $25 | $25 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $63 | $63 | $63 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $82 | $82 | $82 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $250 | $250 | $250 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $175 | $175 | $175 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $66 | $66 | $66 |
| Special stain group II CPT 88313 • Pathology | $7 | $7 | $7 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $92 | $92 | $92 |
| Frozen section pathology each additional CPT 88332 • Pathology | $6 | $6 | $6 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $65 | $65 | $65 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $122 | $122 | $122 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $32 | $32 | $32 |
| Microdissection manual CPT 88381 • Pathology | $75 | $75 | $75 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $8 | $8 | $8 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $19 | $21 | $22 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $22 | $24 | $25 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $18 | $23 | $27 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $17 | $19 | $19 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $37 | $43 | $47 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $23 | $37 | $47 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $34 | $37 | $39 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $18 | $32 | $43 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $29 | $29 | $29 |
| Physical therapy evaluation low complexity CPT 97161 • Physical Therapy | $117 | $122 | $131 |
| Physical therapy evaluation moderate complexity CPT 97162 • Physical Therapy | $115 | $124 | $137 |
| Physical therapy evaluation high complexity CPT 97163 • Physical Therapy | $117 | $119 | $121 |
| Physical therapy re-evaluation CPT 97164 • Physical Therapy | $79 | $88 | $93 |
| Therapeutic activities each 15 minutes CPT 97530 • Physical Therapy | $49 | $54 | $58 |
| Self-care/home management training each 15 min CPT 97535 • Physical Therapy | $42 | $46 | $49 |
| Wheelchair management training each 15 minutes CPT 97542 • Physical Therapy | $45 | $45 | $45 |
| Physical performance test each 15 minutes CPT 97750 • Physical Therapy | $48 | $48 | $48 |
| Orthotic management and training each 15 min CPT 97760 • Physical Therapy | $43 | $55 | $67 |
| Prosthetic training each 15 minutes CPT 97761 • Physical Therapy | $39 | $39 | $39 |