| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $683 | $779 | $875 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $986 | $1,129 | $1,272 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $930 | $1,047 | $1,165 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $1,066 | $1,206 | $1,347 |
| Carpal tunnel release CPT 64721 • Orthopedics | $411 | $469 | $528 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $69 | $193 | $271 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $125 | $238 | $303 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $182 | $182 | $182 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $97 | $158 | $257 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $557 | $1,070 | $1,583 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $72 | $82 | $93 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $56 | $56 | $56 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $313 | $379 | $448 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $61 | $94 | $153 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $204 | $248 | $270 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $105 | $115 | $136 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $153 | $165 | $178 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $511 | $554 | $657 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $224 | $284 | $354 |
| Cytopathology concentration technique CPT 88108 • Pathology | $40 | $40 | $40 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $32 | $32 | $32 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $14 | $14 | $14 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $9 | $9 | $9 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $22 | $22 | $22 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $12 | $12 | $12 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $15 | $15 | $15 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $4 | $4 | $4 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $6 | $6 | $6 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $21 | $21 | $21 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $114 | $114 | $114 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $170 | $170 | $170 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $15 | $15 | $15 |
| Special stain group II CPT 88313 • Pathology | $32 | $32 | $32 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $50 | $50 | $50 |
| Frozen section pathology each additional CPT 88332 • Pathology | $22 | $22 | $22 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $14 | $14 | $14 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $24 | $24 | $24 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $34 | $34 | $34 |
| Microdissection manual CPT 88381 • Pathology | $88 | $88 | $88 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $3 | $4 | $5 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $10 | $15 | $19 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $10 | $11 | $11 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $12 | $12 | $12 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $9 | $10 | $12 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $25 | $27 | $30 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $29 | $30 | $31 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $26 | $30 | $33 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $23 | $25 | $28 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $15 | $17 | $19 |
| Physical therapy evaluation low complexity CPT 97161 • Physical Therapy | $84 | $89 | $95 |