OFFICE VISITS
- New Patient Consult (includes initial UDS): $450
- New Patient Consult (no UDS): $250
- Established Patient Visit: $165
- Urine Toxicology Screen: $200
- Telemedicine Self Pay $165
- IT Pump Refill: $250
PROCEDURES
- 77003 Fluoroscopy: $114
- 20552 Trigger Point Injection: $55
- 20553 Trigger Point Injection: $63
- 20600 Small Bursa Injection: $59
- 20605 Medium Bursa Injection: $60
- 20610 Large Bursa Injection: $73
- 27096 Sacroiliac Joint Injection: $192
- 61070 Pump Dye Study: $56
- 62273 Epidural Blood Patch: $188
- 62290 Lumbar Discogram: $404
- 62291 Cervical Discogram: $368
- 62321 Cervical Epidural Steroid Injection: $300
- 62323 Lumbar Epidural Steroid Injection: $310
- 62362 (pump) + 62350 (catheter) Intrathecal Pump Implant: $438 + $456 = $894
- 62362 Intrathecal Pump Revision: $403
- 62365 Intrathecal Pump Removal: $321
- 62355 Intrathecal Catheter Removal: $305
- 63650 Spinal Cord Stimulator Trial: $2,600
- 63650 (electrode) + 63685 (generator) Spinal Cord Stimulator Implant: $2,600 + $346 = $2,946
- 63663 Spinal Cord Stimulator Electrode Revision: $1,037
- 63688 Spinal Cord Stimulator Generator Revision: $331
- 64400 Trigeminal Nerve Block: $132
- 64405 Greater Occipital Nerve Block: $86
- 64420 Intercostal Nerve Block (single): $115
- 64413 Cervical Plexus Block: $167
- 64415 Brachial Plexus Block: $169
- 64418 Suprascapular Block: $98
- 64420 Intercostal Nerve Block: $115
- 64421 Intercostal Nerve Block (multiple): $115 + $39 = $154
- 64425 Ilioinguinal Nerve Block: $132
- 64430 Pudendal Nerve Block: $104
- 64445 Sciatic/Pyriformis Muscle: $189
- 64450 Peripheral Nerve Block: $88
- 64454 Genicular Nerve Block: $270
- 64479 Cervical Transforaminal Epidural Steroid Injection: $311
- 64480 Cervical Transforaminal Epidural Additional Levels: $156
- 64483 Lumbar Transforaminal Epidural Steroid Injection: $288
- 64484 Lumbar Transforaminal Epidural Additional Levels: $128
- 64490 Cervical Medial Branch Block: $223
- 64491 Cervical Medial Branch Additional Levels: $111
- 64493 Lumbar Medial Branch Block: $207
- 64494 Lumbar Medial Branch Additional Levels: $105
- 64495 ^ third additional levels: $105
- 64505 Sphenopalatine: $163
- 64510 Stellate Ganglion Block: $168
- 64517 Superior Hypogas: $221
- 64520 Paravertebral Sympathetic Nerve Block: $264
- 64530 Celiac Plexus Nerve Block: $257
- 64600 Trigeminal Nerve Block: $576
- 64615 Botox: $170 + $100 Flouro (if used)
- 64624 / 64625 Genicular Radiofrequency: $700
- 64633 Cervical Radiofrequency: $500
- 64635 Lumbar Radiofrequency: $506
- 64636 Radiofrequency additional levels: $274
DME
- Back Brace: $200
- Knee Brace: $210
- TENS Unit: $50
- TENS Pad Pack: $35
- TENS Pad Single: $10
VIRTUAL SERVICES
- Chronic Care Management (CCM): $100 monthly
- Principal Care Management (PCM): $100 monthly
- Remote Therapeutic Monitoring (RTM): $100 monthly