| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $42 | $906 | $1,448 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $42 | $1,292 | $2,054 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $949 | $1,336 | $1,872 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $1,353 | $1,810 | $2,126 |
| Carpal tunnel release CPT 64721 • Orthopedics | $76 | $470 | $829 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $110 | $257 | $334 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $190 | $360 | $513 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $36 | $161 | $288 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $176 | $290 | $488 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $357 | $1,796 | $4,475 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $10 | $66 | $146 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $29 | $54 | $69 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $30 | $241 | $451 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $15 | $103 | $199 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $105 | $200 | $331 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $44 | $93 | $127 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $150 | $204 | $287 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $360 | $544 | $794 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $105 | $301 | $471 |
| Cytopathology concentration technique CPT 88108 • Pathology | $14 | $30 | $45 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $17 | $29 | $45 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $10 | $14 | $20 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $2 | $6 | $9 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $12 | $16 | $19 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $3 | $8 | $13 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $4 | $12 | $20 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $4 | $13 | $20 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $19 | $23 | $29 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $18 | $24 | $33 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $143 | $166 | $195 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $93 | $211 | $296 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $12 | $39 | $61 |
| Special stain group II CPT 88313 • Pathology | $22 | $33 | $43 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $20 | $29 | $38 |
| Frozen section pathology each additional CPT 88332 • Pathology | $19 | $27 | $32 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $17 | $30 | $56 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $22 | $41 | $67 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $33 | $38 | $46 |
| Microdissection manual CPT 88381 • Pathology | $74 | $79 | $87 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $5 | $6 | $9 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $12 | $16 | $22 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $8 | $14 | $21 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $14 | $20 | $26 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $7 | $16 | $26 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $19 | $24 | $31 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $23 | $38 | $61 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $17 | $24 | $31 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $19 | $31 | $49 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $10 | $13 | $19 |
| Physical therapy evaluation low complexity CPT 97161 • Physical Therapy | $49 | $98 | $181 |