| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $94 | $1,180 | $2,267 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $45 | $1,255 | $3,209 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $180 | $1,327 | $3,121 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $204 | $1,509 | $3,551 |
| Carpal tunnel release CPT 64721 • Orthopedics | $264 | $742 | $1,376 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $101 | $265 | $523 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $73 | $300 | $797 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $12 | $126 | $291 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $112 | $200 | $332 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $53 | $675 | $1,375 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $4 | $130 | $257 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $41 | $88 | $157 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $183 | $363 | $713 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $55 | $115 | $175 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $144 | $297 | $561 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $55 | $148 | $282 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $13 | $207 | $405 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $174 | $390 | $747 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $10 | $216 | $569 |
| Cytopathology concentration technique CPT 88108 • Pathology | $22 | $33 | $39 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $32 | $39 | $42 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $4 | $18 | $30 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $4 | $9 | $14 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $4 | $29 | $58 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $2 | $11 | $20 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $4 | $18 | $30 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $10 | $17 | $21 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $11 | $21 | $26 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $18 | $43 | $67 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $54 | $136 | $190 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $127 | $175 | $253 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $17 | $47 | $62 |
| Special stain group II CPT 88313 • Pathology | $8 | $37 | $62 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $30 | $63 | $95 |
| Frozen section pathology each additional CPT 88332 • Pathology | $12 | $25 | $33 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $11 | $41 | $69 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $23 | $47 | $66 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $52 | $87 | $123 |
| Microdissection manual CPT 88381 • Pathology | $60 | $149 | $236 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $3 | $7 | $13 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $9 | $19 | $35 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $11 | $21 | $42 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $10 | $21 | $43 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $7 | $20 | $29 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $18 | $47 | $71 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $19 | $40 | $74 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $15 | $33 | $63 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $16 | $33 | $67 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $10 | $29 | $39 |
| Physical therapy evaluation low complexity CPT 97161 • Physical Therapy | $46 | $97 | $180 |