| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $30 | $727 | $1,054 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $30 | $671 | $1,324 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $44 | $950 | $1,324 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $30 | $773 | $1,454 |
| Carpal tunnel release CPT 64721 • Orthopedics | $291 | $524 | $673 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $96 | $143 | $173 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $53 | $237 | $351 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $8 | $121 | $220 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $14 | $328 | $840 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $596 | $1,553 | $2,386 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $6 | $52 | $94 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $35 | $59 | $79 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $104 | $297 | $412 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $30 | $88 | $117 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $93 | $197 | $235 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $53 | $99 | $121 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $11 | $149 | $203 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $67 | $388 | $651 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $27 | $154 | $273 |
| Cytopathology concentration technique CPT 88108 • Pathology | $25 | $44 | $81 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $20 | $56 | $90 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $3 | $16 | $28 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $2 | $11 | $21 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $22 | $39 | $58 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $2 | $9 | $12 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $9 | $23 | $43 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $4 | $16 | $40 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $6 | $33 | $57 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $22 | $58 | $96 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $124 | $220 | $380 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $83 | $297 | $550 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $13 | $66 | $142 |
| Special stain group II CPT 88313 • Pathology | $7 | $48 | $102 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $35 | $49 | $60 |
| Frozen section pathology each additional CPT 88332 • Pathology | $16 | $36 | $69 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $40 | $74 | $112 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $33 | $65 | $128 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $38 | $47 | $54 |
| Microdissection manual CPT 88381 • Pathology | $34 | $136 | $263 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $4 | $8 | $14 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $7 | $18 | $32 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $16 | $20 | $31 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $9 | $20 | $35 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $12 | $15 | $19 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $25 | $32 | $40 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $27 | $46 | $82 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $25 | $32 | $40 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $23 | $31 | $39 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $15 | $19 | $24 |
| Physical therapy evaluation low complexity CPT 97161 • Physical Therapy | $31 | $91 | $136 |