| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $495 | $1,045 | $1,594 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $1,567 | $2,053 | $2,342 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $34 | $1,036 | $2,090 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $1,118 | $1,589 | $2,531 |
| Carpal tunnel release CPT 64721 • Orthopedics | $424 | $626 | $1,028 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $186 | $332 | $436 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $18 | $309 | $601 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $18 | $236 | $372 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $42 | $304 | $592 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $34 | $2,367 | $6,112 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $41 | $138 | $201 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $42 | $58 | $78 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $11 | $286 | $563 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $10 | $65 | $119 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $100 | $165 | $208 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $43 | $115 | $208 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $156 | $207 | $279 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $50 | $520 | $1,012 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $13 | $403 | $644 |
| Cytopathology concentration technique CPT 88108 • Pathology | $17 | $30 | $44 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $21 | $50 | $68 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $3 | $12 | $18 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $8 | $12 | $14 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $19 | $24 | $31 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $7 | $12 | $17 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $3 | $15 | $25 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $5 | $23 | $33 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $9 | $22 | $39 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $29 | $53 | $77 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $129 | $211 | $285 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $97 | $134 | $193 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $61 | $70 | $83 |
| Special stain group II CPT 88313 • Pathology | $45 | $62 | $80 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $34 | $49 | $78 |
| Frozen section pathology each additional CPT 88332 • Pathology | $19 | $22 | $24 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $22 | $53 | $96 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $27 | $39 | $60 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $32 | $39 | $42 |
| Microdissection manual CPT 88381 • Pathology | $18 | $95 | $134 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $3 | $4 | $6 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $10 | $17 | $30 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $10 | $17 | $28 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $11 | $12 | $14 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $8 | $11 | $14 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $20 | $24 | $29 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $21 | $45 | $82 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $25 | $26 | $29 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $23 | $25 | $26 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $12 | $14 | $17 |
| Physical therapy evaluation low complexity CPT 97161 • Physical Therapy | $57 | $80 | $98 |