| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $2,381 | $2,623 | $2,865 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $1,282 | $2,206 | $3,131 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $1,457 | $2,503 | $3,549 |
| Carpal tunnel release CPT 64721 • Orthopedics | $528 | $865 | $1,202 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $95 | $276 | $463 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $125 | $209 | $303 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $130 | $197 | $263 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $149 | $494 | $840 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $2,379 | $4,964 | $7,550 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $93 | $116 | $140 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $55 | $67 | $79 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $448 | $490 | $532 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $215 | $235 | $256 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $126 | $165 | $204 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $105 | $114 | $130 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $178 | $204 | $222 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $511 | $726 | $1,155 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $278 | $349 | $490 |
| Cytopathology concentration technique CPT 88108 • Pathology | $81 | $97 | $113 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $38 | $61 | $84 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $23 | $26 | $28 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $12 | $16 | $21 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $29 | $32 | $35 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $28 | $41 | $54 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $24 | $33 | $43 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $12 | $26 | $40 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $16 | $34 | $52 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $23 | $33 | $42 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $105 | $233 | $361 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $239 | $394 | $550 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $65 | $104 | $142 |
| Special stain group II CPT 88313 • Pathology | $7 | $54 | $102 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $58 | $69 | $80 |
| Frozen section pathology each additional CPT 88332 • Pathology | $9 | $39 | $69 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $112 | $115 | $118 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $73 | $100 | $128 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $59 | $106 | $153 |
| Microdissection manual CPT 88381 • Pathology | $85 | $174 | $263 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $5 | $10 | $14 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $15 | $17 | $19 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $21 | $25 | $28 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $22 | $28 | $35 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $14 | $24 | $34 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $31 | $51 | $71 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $31 | $55 | $82 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $21 | $24 | $27 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $25 | $44 | $65 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $20 | $31 | $42 |
| Physical therapy evaluation low complexity CPT 97161 • Physical Therapy | $75 | $162 | $241 |
| Physical therapy evaluation moderate complexity CPT 97162 • Physical Therapy | $71 | $108 | $170 |