| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $30 | $393 | $757 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $30 | $688 | $1,346 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $30 | $1,045 | $1,937 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $1,393 | $1,801 | $2,209 |
| Carpal tunnel release CPT 64721 • Orthopedics | $30 | $446 | $850 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $16 | $93 | $171 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $258 | $310 | $361 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $130 | $130 | $130 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $10 | $138 | $254 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $343 | $1,152 | $1,960 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $6 | $72 | $136 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $33 | $60 | $95 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $233 | $331 | $430 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $30 | $136 | $242 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $339 | $384 | $430 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $89 | $118 | $172 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $150 | $208 | $287 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $351 | $534 | $813 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $94 | $191 | $240 |
| Cytopathology concentration technique CPT 88108 • Pathology | $14 | $37 | $49 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $51 | $63 | $75 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $17 | $24 | $31 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $12 | $15 | $21 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $21 | $21 | $21 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $3 | $21 | $43 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $19 | $22 | $25 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $5 | $33 | $60 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $7 | $19 | $31 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $82 | $82 | $82 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $123 | $187 | $219 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $264 | $299 | $333 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $16 | $51 | $86 |
| Special stain group II CPT 88313 • Pathology | $18 | $47 | $62 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $16 | $54 | $92 |
| Frozen section pathology each additional CPT 88332 • Pathology | $19 | $30 | $41 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $32 | $56 | $68 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $27 | $75 | $122 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $32 | $63 | $92 |
| Microdissection manual CPT 88381 • Pathology | $15 | $87 | $159 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $5 | $5 | $6 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $10 | $13 | $20 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $9 | $12 | $18 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $12 | $14 | $19 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $12 | $17 | $22 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $31 | $43 | $55 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $28 | $34 | $41 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $24 | $28 | $34 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $22 | $29 | $37 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $17 | $23 | $30 |
| Physical therapy evaluation low complexity CPT 97161 • Physical Therapy | $83 | $101 | $118 |