| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $9 | $258 | $450 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $1,789 | $3,761 | $7,260 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $8 | $93 | $136 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $36 | $36 | $37 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $78 | $450 | $1,184 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $56 | $95 | $149 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $84 | $267 | $438 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $40 | $85 | $148 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $107 | $280 | $485 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $126 | $596 | $1,051 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $8 | $142 | $287 |
| Cytopathology concentration technique CPT 88108 • Pathology | $14 | $47 | $109 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $39 | $59 | $108 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $6 | $20 | $38 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $2 | $16 | $30 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $15 | $25 | $45 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $12 | $20 | $36 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $9 | $37 | $54 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $9 | $25 | $52 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $6 | $25 | $68 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $21 | $64 | $115 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $117 | $231 | $456 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $92 | $292 | $687 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $34 | $91 | $178 |
| Special stain group II CPT 88313 • Pathology | $10 | $43 | $130 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $35 | $85 | $110 |
| Frozen section pathology each additional CPT 88332 • Pathology | $14 | $44 | $87 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $10 | $62 | $144 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $22 | $79 | $168 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $48 | $70 | $95 |
| Microdissection manual CPT 88381 • Pathology | $45 | $146 | $316 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $4 | $11 | $19 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $8 | $23 | $38 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $7 | $9 | $11 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $9 | $29 | $44 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $9 | $25 | $44 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $18 | $29 | $36 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $21 | $62 | $104 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $18 | $25 | $31 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $17 | $24 | $30 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $11 | $13 | $16 |
| Physical therapy evaluation low complexity CPT 97161 • Physical Therapy | $81 | $157 | $308 |
| Physical therapy evaluation moderate complexity CPT 97162 • Physical Therapy | $83 | $105 | $166 |
| Physical therapy evaluation high complexity CPT 97163 • Physical Therapy | $81 | $83 | $88 |
| Physical therapy re-evaluation CPT 97164 • Physical Therapy | $60 | $75 | $83 |
| Therapeutic activities each 15 minutes CPT 97530 • Physical Therapy | $34 | $60 | $83 |
| Self-care/home management training each 15 min CPT 97535 • Physical Therapy | $81 | $88 | $100 |
| Wheelchair management training each 15 minutes CPT 97542 • Physical Therapy | $34 | $66 | $83 |
| Physical performance test each 15 minutes CPT 97750 • Physical Therapy | $81 | $89 | $103 |
| Orthotic management and training each 15 min CPT 97760 • Physical Therapy | $30 | $87 | $147 |