| Sacroiliac joint injection CPT 27096 • Pain Management | $97 | $2,909 | $15,000 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $57 | $391 | $750 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $57 | $385 | $750 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $57 | $469 | $750 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $519 | $5,505 | $28,516 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $57 | $2,820 | $15,000 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $28 | $354 | $750 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $96 | $5,749 | $32,000 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $97 | $3,593 | $19,682 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $167 | $5,427 | $30,000 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $97 | $536 | $750 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $57 | $415 | $750 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $519 | $7,322 | $40,000 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $57 | $429 | $750 |
| Unlisted nervous system procedure CPT 64999 • Pain Management | $57 | $348 | $750 |
| Cytopathology concentration technique CPT 88108 • Pathology | $26 | $26 | $26 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $16 | $23 | $31 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $11 | $13 | $14 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $11 | $11 | $11 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $13 | $15 | $16 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $13 | $13 | $13 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $19 | $19 | $19 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $15 | $15 | $15 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $18 | $19 | $19 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $17 | $31 | $60 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $162 | $162 | $162 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $81 | $81 | $81 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $39 | $69 | $94 |
| Special stain group II CPT 88313 • Pathology | $7 | $25 | $67 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $35 | $35 | $35 |
| Frozen section pathology each additional CPT 88332 • Pathology | $17 | $17 | $17 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $35 | $51 | $74 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $35 | $70 | $84 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $45 | $45 | $45 |
| Microdissection manual CPT 88381 • Pathology | $112 | $112 | $112 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $5 | $9 | $11 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $11 | $16 | $21 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $8 | $15 | $20 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $12 | $21 | $25 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $10 | $18 | $25 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $20 | $37 | $51 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $23 | $42 | $58 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $20 | $37 | $51 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $19 | $34 | $47 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $14 | $23 | $31 |
| Physical therapy evaluation low complexity CPT 97161 • Physical Therapy | $75 | $127 | $173 |
| Physical therapy evaluation moderate complexity CPT 97162 • Physical Therapy | $76 | $127 | $173 |
| Physical therapy evaluation high complexity CPT 97163 • Physical Therapy | $76 | $127 | $173 |
| Physical therapy re-evaluation CPT 97164 • Physical Therapy | $52 | $88 | $119 |
| Therapeutic activities each 15 minutes CPT 97530 • Physical Therapy | $26 | $46 | $64 |