| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $1,054 | $1,170 | $1,285 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $1,006 | $1,285 | $1,500 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $1,039 | $1,480 | $1,986 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $204 | $1,137 | $2,014 |
| Carpal tunnel release CPT 64721 • Orthopedics | $440 | $610 | $780 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $170 | $213 | $297 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $200 | $254 | $284 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $82 | $183 | $285 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $357 | $400 | $444 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $596 | $625 | $655 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $65 | $111 | $158 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $49 | $65 | $79 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $212 | $318 | $374 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $19 | $122 | $232 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $124 | $192 | $269 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $94 | $125 | $160 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $123 | $177 | $232 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $318 | $524 | $817 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $86 | $127 | $181 |
| Cytopathology concentration technique CPT 88108 • Pathology | $36 | $55 | $74 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $23 | $72 | $121 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $21 | $23 | $26 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $17 | $21 | $26 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $39 | $53 | $64 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $14 | $25 | $35 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $21 | $22 | $22 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $15 | $33 | $50 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $21 | $43 | $65 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $26 | $26 | $26 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $57 | $152 | $205 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $272 | $290 | $307 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $44 | $68 | $92 |
| Special stain group II CPT 88313 • Pathology | $67 | $90 | $113 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $28 | $47 | $66 |
| Frozen section pathology each additional CPT 88332 • Pathology | $43 | $46 | $49 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $30 | $30 | $30 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $89 | $94 | $98 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $28 | $64 | $100 |
| Microdissection manual CPT 88381 • Pathology | $92 | $113 | $135 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $4 | $5 | $7 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $8 | $12 | $16 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $7 | $15 | $22 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $9 | $17 | $24 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $9 | $17 | $26 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $19 | $29 | $45 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $22 | $36 | $46 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $19 | $32 | $40 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $18 | $31 | $39 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $11 | $20 | $29 |
| Physical therapy evaluation low complexity CPT 97161 • Physical Therapy | $100 | $107 | $115 |