| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $602 | $749 | $897 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $1,287 | $1,305 | $1,324 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $1,229 | $1,607 | $1,986 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $305 | $855 | $1,406 |
| Carpal tunnel release CPT 64721 • Orthopedics | $537 | $556 | $576 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $232 | $252 | $272 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $351 | $403 | $456 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $220 | $220 | $220 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $345 | $397 | $449 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $1,891 | $2,062 | $2,232 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $133 | $135 | $136 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $66 | $67 | $68 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $146 | $665 | $1,184 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $149 | $163 | $178 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $224 | $229 | $234 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $115 | $132 | $148 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $183 | $191 | $199 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $318 | $485 | $651 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $68 | $170 | $273 |
| Cytopathology concentration technique CPT 88108 • Pathology | $16 | $55 | $109 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $25 | $61 | $108 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $16 | $27 | $38 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $9 | $20 | $30 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $22 | $42 | $58 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $12 | $24 | $36 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $17 | $42 | $54 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $12 | $23 | $30 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $7 | $22 | $40 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $22 | $60 | $87 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $48 | $120 | $183 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $83 | $343 | $687 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $42 | $89 | $178 |
| Special stain group II CPT 88313 • Pathology | $7 | $53 | $130 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $36 | $70 | $110 |
| Frozen section pathology each additional CPT 88332 • Pathology | $24 | $55 | $87 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $27 | $94 | $144 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $28 | $61 | $97 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $66 | $77 | $95 |
| Microdissection manual CPT 88381 • Pathology | $45 | $158 | $316 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $5 | $5 | $5 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $14 | $16 | $19 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $16 | $16 | $16 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $17 | $25 | $33 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $12 | $15 | $18 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $26 | $37 | $55 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $27 | $35 | $47 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $25 | $31 | $37 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $27 | $30 | $34 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $18 | $18 | $18 |
| Physical therapy evaluation low complexity CPT 97161 • Physical Therapy | $81 | $94 | $117 |