| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $223 | $477 | $732 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $669 | $1,452 | $2,236 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $141 | $724 | $1,888 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $340 | $1,291 | $2,242 |
| Carpal tunnel release CPT 64721 • Orthopedics | $43 | $337 | $536 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $30 | $80 | $157 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $16 | $92 | $167 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $60 | $97 | $134 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $10 | $279 | $549 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $98 | $1,053 | $2,008 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $30 | $118 | $251 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $33 | $51 | $72 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $26 | $238 | $451 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $8 | $182 | $435 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $143 | $231 | $386 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $67 | $95 | $147 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $23 | $173 | $324 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $131 | $407 | $682 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $24 | $225 | $367 |
| Cytopathology concentration technique CPT 88108 • Pathology | $19 | $34 | $49 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $13 | $21 | $26 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $3 | $12 | $20 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $9 | $11 | $13 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $18 | $20 | $21 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $3 | $17 | $31 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $13 | $20 | $28 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $3 | $5 | $7 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $5 | $14 | $32 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $15 | $27 | $48 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $37 | $98 | $219 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $134 | $150 | $167 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $13 | $34 | $55 |
| Special stain group II CPT 88313 • Pathology | $5 | $14 | $23 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $16 | $38 | $59 |
| Frozen section pathology each additional CPT 88332 • Pathology | $14 | $19 | $24 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $11 | $31 | $68 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $16 | $29 | $43 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $27 | $60 | $92 |
| Microdissection manual CPT 88381 • Pathology | $19 | $92 | $159 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $5 | $5 | $5 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $10 | $16 | $30 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $9 | $11 | $15 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $11 | $18 | $38 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $11 | $14 | $24 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $20 | $32 | $58 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $23 | $36 | $61 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $20 | $30 | $51 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $19 | $30 | $55 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $14 | $15 | $15 |
| Physical therapy evaluation low complexity CPT 97161 • Physical Therapy | $42 | $100 | $182 |