| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $226 | $255 | $284 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $80 | $80 | $80 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $222 | $290 | $357 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $596 | $596 | $596 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $117 | $117 | $117 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $44 | $55 | $66 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $259 | $286 | $312 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $48 | $70 | $91 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $153 | $252 | $351 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $79 | $130 | $181 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $136 | $170 | $203 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $250 | $350 | $421 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $68 | $147 | $225 |
| Cytopathology concentration technique CPT 88108 • Pathology | $51 | $51 | $51 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $50 | $50 | $50 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $18 | $18 | $18 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $14 | $14 | $14 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $21 | $39 | $58 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $25 | $25 | $25 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $25 | $25 | $25 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $24 | $24 | $24 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $31 | $31 | $31 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $213 | $221 | $229 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $321 | $321 | $321 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $83 | $83 | $83 |
| Special stain group II CPT 88313 • Pathology | $61 | $61 | $61 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $28 | $28 | $28 |
| Frozen section pathology each additional CPT 88332 • Pathology | $41 | $41 | $41 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $67 | $67 | $67 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $78 | $78 | $78 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $89 | $89 | $89 |
| Microdissection manual CPT 88381 • Pathology | $147 | $147 | $147 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $3 | $4 | $5 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $12 | $16 | $19 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $6 | $6 | $6 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $16 | $17 | $18 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $8 | $13 | $17 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $17 | $27 | $37 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $20 | $34 | $48 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $20 | $29 | $37 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $19 | $27 | $34 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $10 | $10 | $10 |
| Physical therapy evaluation low complexity CPT 97161 • Physical Therapy | $59 | $87 | $115 |
| Physical therapy evaluation moderate complexity CPT 97162 • Physical Therapy | $92 | $105 | $117 |
| Physical therapy evaluation high complexity CPT 97163 • Physical Therapy | $59 | $88 | $117 |
| Physical therapy re-evaluation CPT 97164 • Physical Therapy | $50 | $64 | $79 |
| Therapeutic activities each 15 minutes CPT 97530 • Physical Therapy | $35 | $44 | $54 |
| Self-care/home management training each 15 min CPT 97535 • Physical Therapy | $19 | $33 | $47 |
| Wheelchair management training each 15 minutes CPT 97542 • Physical Therapy | $18 | $20 | $23 |
| Physical performance test each 15 minutes CPT 97750 • Physical Therapy | $20 | $34 | $48 |