| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $158 | $248 | $392 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $27 | $140 | $246 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $155 | $335 | $466 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $333 | $1,068 | $2,119 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $11 | $88 | $176 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $32 | $66 | $91 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $9 | $271 | $444 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $11 | $172 | $305 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $58 | $224 | $318 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $45 | $161 | $274 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $18 | $174 | $276 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $99 | $542 | $797 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $31 | $257 | $435 |
| Cytopathology concentration technique CPT 88108 • Pathology | $5 | $37 | $63 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $51 | $80 | $125 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $3 | $16 | $23 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $2 | $10 | $17 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $5 | $23 | $37 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $7 | $22 | $37 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $18 | $27 | $33 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $15 | $21 | $31 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $8 | $24 | $40 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $13 | $42 | $68 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $50 | $140 | $275 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $87 | $210 | $416 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $22 | $63 | $106 |
| Special stain group II CPT 88313 • Pathology | $7 | $33 | $77 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $28 | $45 | $70 |
| Frozen section pathology each additional CPT 88332 • Pathology | $6 | $31 | $53 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $9 | $54 | $82 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $45 | $67 | $95 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $34 | $62 | $111 |
| Microdissection manual CPT 88381 • Pathology | $119 | $174 | $213 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $3 | $6 | $8 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $8 | $15 | $21 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $9 | $14 | $19 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $10 | $18 | $27 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $7 | $14 | $18 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $25 | $34 | $41 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $18 | $35 | $43 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $15 | $29 | $38 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $23 | $32 | $38 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $11 | $20 | $27 |
| Physical therapy evaluation low complexity CPT 97161 • Physical Therapy | $84 | $113 | $128 |
| Physical therapy evaluation moderate complexity CPT 97162 • Physical Therapy | $84 | $113 | $128 |
| Physical therapy evaluation high complexity CPT 97163 • Physical Therapy | $24 | $93 | $128 |
| Physical therapy re-evaluation CPT 97164 • Physical Therapy | $17 | $64 | $88 |
| Therapeutic activities each 15 minutes CPT 97530 • Physical Therapy | $31 | $43 | $51 |
| Self-care/home management training each 15 min CPT 97535 • Physical Therapy | $27 | $38 | $46 |
| Wheelchair management training each 15 minutes CPT 97542 • Physical Therapy | $16 | $32 | $41 |