| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $1,372 | $1,468 | $1,565 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $1,294 | $1,374 | $1,454 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $176 | $1,140 | $1,761 |
| Carpal tunnel release CPT 64721 • Orthopedics | $440 | $626 | $724 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $110 | $125 | $133 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $170 | $195 | $242 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $126 | $128 | $129 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $85 | $303 | $413 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $1,841 | $3,041 | $3,645 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $67 | $93 | $120 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $44 | $68 | $80 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $232 | $353 | $436 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $83 | $133 | $212 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $251 | $302 | $375 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $127 | $139 | $145 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $236 | $240 | $244 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $704 | $705 | $706 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $383 | $384 | $384 |
| Cytopathology concentration technique CPT 88108 • Pathology | $39 | $60 | $80 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $31 | $58 | $81 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $11 | $26 | $36 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $11 | $13 | $14 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $12 | $34 | $54 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $13 | $15 | $17 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $21 | $30 | $39 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $5 | $37 | $69 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $19 | $23 | $32 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $17 | $41 | $55 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $173 | $196 | $219 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $176 | $198 | $220 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $15 | $62 | $130 |
| Special stain group II CPT 88313 • Pathology | $10 | $44 | $90 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $31 | $46 | $61 |
| Frozen section pathology each additional CPT 88332 • Pathology | $14 | $28 | $42 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $31 | $52 | $74 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $51 | $108 | $160 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $77 | $81 | $86 |
| Microdissection manual CPT 88381 • Pathology | $14 | $87 | $160 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $5 | $8 | $11 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $11 | $20 | $27 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $15 | $19 | $22 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $16 | $23 | $27 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $12 | $21 | $26 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $20 | $37 | $51 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $23 | $37 | $58 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $20 | $32 | $51 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $24 | $40 | $49 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $14 | $20 | $31 |
| Physical therapy evaluation low complexity CPT 97161 • Physical Therapy | $132 | $168 | $200 |
| Physical therapy evaluation moderate complexity CPT 97162 • Physical Therapy | $76 | $113 | $173 |