| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $30 | $415 | $674 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $30 | $401 | $771 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $30 | $627 | $1,096 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $860 | $1,052 | $1,243 |
| Carpal tunnel release CPT 64721 • Orthopedics | $30 | $282 | $486 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $146 | $152 | $159 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $190 | $243 | $281 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $118 | $118 | $118 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $10 | $121 | $278 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $995 | $1,355 | $1,716 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $15 | $47 | $80 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $37 | $43 | $53 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $190 | $221 | $252 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $30 | $57 | $84 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $73 | $132 | $192 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $44 | $70 | $97 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $102 | $139 | $166 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $350 | $426 | $468 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $148 | $199 | $260 |
| Cytopathology concentration technique CPT 88108 • Pathology | $18 | $40 | $51 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $57 | $64 | $71 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $20 | $23 | $27 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $10 | $11 | $13 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $21 | $24 | $25 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $3 | $13 | $20 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $20 | $20 | $20 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $26 | $32 | $37 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $34 | $35 | $36 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $25 | $25 | $25 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $157 | $215 | $260 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $238 | $293 | $349 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $74 | $80 | $85 |
| Special stain group II CPT 88313 • Pathology | $8 | $44 | $62 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $31 | $50 | $79 |
| Frozen section pathology each additional CPT 88332 • Pathology | $8 | $26 | $45 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $45 | $64 | $79 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $28 | $56 | $91 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $50 | $67 | $92 |
| Microdissection manual CPT 88381 • Pathology | $92 | $112 | $131 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $4 | $4 | $5 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $9 | $10 | $11 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $9 | $11 | $14 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $11 | $12 | $14 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $9 | $10 | $12 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $23 | $23 | $23 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $24 | $25 | $27 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $19 | $21 | $25 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $18 | $20 | $22 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $12 | $13 | $15 |
| Physical therapy evaluation low complexity CPT 97161 • Physical Therapy | $55 | $58 | $60 |