| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $467 | $1,479 | $2,491 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $176 | $230 | $284 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $54 | $72 | $90 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $270 | $473 | $677 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $112 | $215 | $319 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $194 | $384 | $574 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $44 | $120 | $215 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $170 | $225 | $281 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $332 | $559 | $885 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $136 | $255 | $374 |
| Cytopathology concentration technique CPT 88108 • Pathology | $54 | $56 | $57 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $58 | $143 | $228 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $19 | $30 | $41 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $14 | $20 | $27 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $25 | $46 | $67 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $4 | $26 | $54 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $30 | $40 | $50 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $27 | $50 | $72 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $22 | $29 | $36 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $78 | $78 | $78 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $188 | $261 | $348 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $233 | $306 | $379 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $55 | $76 | $96 |
| Special stain group II CPT 88313 • Pathology | $32 | $70 | $109 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $57 | $89 | $122 |
| Frozen section pathology each additional CPT 88332 • Pathology | $17 | $32 | $48 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $80 | $87 | $94 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $82 | $86 | $91 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $107 | $157 | $208 |
| Microdissection manual CPT 88381 • Pathology | $99 | $135 | $172 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $4 | $5 | $8 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $9 | $17 | $25 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $9 | $17 | $25 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $11 | $19 | $28 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $10 | $16 | $21 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $22 | $36 | $49 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $20 | $36 | $52 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $21 | $32 | $43 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $16 | $31 | $46 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $13 | $22 | $31 |
| Physical therapy evaluation low complexity CPT 97161 • Physical Therapy | $75 | $113 | $152 |
| Physical therapy evaluation moderate complexity CPT 97162 • Physical Therapy | $71 | $111 | $152 |
| Physical therapy evaluation high complexity CPT 97163 • Physical Therapy | $152 | $170 | $189 |
| Physical therapy re-evaluation CPT 97164 • Physical Therapy | $33 | $62 | $104 |
| Therapeutic activities each 15 minutes CPT 97530 • Physical Therapy | $27 | $39 | $52 |
| Self-care/home management training each 15 min CPT 97535 • Physical Therapy | $25 | $39 | $53 |
| Wheelchair management training each 15 minutes CPT 97542 • Physical Therapy | $20 | $31 | $49 |
| Physical performance test each 15 minutes CPT 97750 • Physical Therapy | $25 | $39 | $53 |
| Orthotic management and training each 15 min CPT 97760 • Physical Therapy | $34 | $44 | $55 |
| Prosthetic training each 15 minutes CPT 97761 • Physical Therapy | $31 | $40 | $50 |