| MRI - Back (outpatient) | $2,028 | N/A | $2,028 |
| Physical Therapy - Electrical Stimulation Therapy | $78 | 
Below Average
State Average: 3 | $78 |
| Physical Therapy - Low Complexity Evaluation | $210 | 
Near Average
State Average: 1 | $210 |
| Physical Therapy - Manual Electrical Stimulation Therapy, 15 minutes | $59 |
Below Average
State Average: 3 | $59 |
| Physical Therapy - Manual Therapy | $58 |
Near Average
State Average: 4 | $58 |
| Physical Therapy - Moderate Complexity Evaluation | $263 |
Near Average
State Average: 1 | $263 |
| Physical Therapy - Neuromuscular Reeducation | $71 |
Below Average
State Average: 4 | $71 |
| Physical Therapy - Re-Evaluation | $158 |
Near Average
State Average: 1 | $158 |
| Physical Therapy - Therapeutic Activities | $87 |
Below Average
State Average: 3 | $87 |
| Physical Therapy - Therapeutic Exercises | $71 |
Near Average
State Average: 4 | $71 |
| Physical Therapy - Ultrasound Therapy | $53 |
Below Average
State Average: 3 | $53 |
| X-Ray - Middle Back, Thoracic Spine | $561 | N/A | $561 |
| X-Ray - Neck, Cervical Spine | $326 | N/A | $326 |
| X-Ray - Spine (outpatient) | $465 | N/A | $465 |
