| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $584 | $761 | $937 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $824 | $1,076 | $1,329 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $1,319 | $1,319 | $1,319 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $1,497 | $1,497 | $1,497 |
| Carpal tunnel release CPT 64721 • Orthopedics | $588 | $588 | $588 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $110 | $150 | $216 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $88 | $225 | $346 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $66 | $133 | $200 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $85 | $214 | $342 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $1,841 | $2,192 | $2,542 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $34 | $68 | $102 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $44 | $55 | $65 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $96 | $123 | $151 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $139 | $147 | $155 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $231 | $241 | $251 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $70 | $91 | $127 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $167 | $167 | $167 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $366 | $460 | $554 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $200 | $214 | $228 |
| Cytopathology concentration technique CPT 88108 • Pathology | $24 | $24 | $24 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $17 | $24 | $31 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $11 | $14 | $16 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $9 | $9 | $9 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $13 | $15 | $16 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $13 | $16 | $18 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $21 | $24 | $27 |
| 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 | $18 | $19 | $19 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $17 | $22 | $30 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $52 | $147 | $242 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $257 | $257 | $257 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $39 | $52 | $64 |
| Special stain group II CPT 88313 • Pathology | $8 | $20 | $32 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $39 | $62 | $85 |
| Frozen section pathology each additional CPT 88332 • Pathology | $14 | $14 | $14 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $39 | $41 | $44 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $42 | $47 | $52 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $50 | $57 | $64 |
| Microdissection manual CPT 88381 • Pathology | $110 | $138 | $167 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $4 | $5 | $6 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $8 | $11 | $13 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $8 | $9 | $11 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $9 | $11 | $14 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $9 | $11 | $13 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $20 | $23 | $28 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $23 | $26 | $32 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $20 | $23 | $28 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $18 | $21 | $26 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $12 | $14 | $17 |
| Physical therapy evaluation low complexity CPT 97161 • Physical Therapy | $75 | $77 | $79 |