| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $439 | $1,002 | $1,564 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $617 | $1,601 | $2,220 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $136 | $1,381 | $2,180 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $1,075 | $1,922 | $2,475 |
| Carpal tunnel release CPT 64721 • Orthopedics | $265 | $714 | $978 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $13 | $181 | $361 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $215 | $350 | $575 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $20 | $177 | $335 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $13 | $366 | $568 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $1,102 | $3,293 | $4,584 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $39 | $98 | $171 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $33 | $71 | $101 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $243 | $420 | $525 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $45 | $138 | $232 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $144 | $234 | $353 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $73 | $151 | $199 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $18 | $220 | $334 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $38 | $477 | $885 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $240 | $368 | $483 |
| Cytopathology concentration technique CPT 88108 • Pathology | $20 | $32 | $39 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $21 | $43 | $65 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $4 | $15 | $25 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $8 | $11 | $15 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $20 | $23 | $27 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $2 | $12 | $21 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $20 | $27 | $33 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $5 | $18 | $29 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $12 | $18 | $25 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $29 | $29 | $30 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $83 | $111 | $165 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $253 | $254 | $256 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $27 | $58 | $86 |
| Special stain group II CPT 88313 • Pathology | $9 | $45 | $72 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $33 | $38 | $40 |
| Frozen section pathology each additional CPT 88332 • Pathology | $20 | $35 | $53 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $22 | $46 | $60 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $36 | $55 | $77 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $35 | $69 | $121 |
| Microdissection manual CPT 88381 • Pathology | $75 | $99 | $146 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $3 | $4 | $6 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $10 | $14 | $19 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $11 | $14 | $18 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $10 | $12 | $15 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $7 | $14 | $22 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $25 | $33 | $44 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $19 | $35 | $51 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $25 | $33 | $44 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $16 | $22 | $28 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $15 | $20 | $27 |
| Physical therapy evaluation low complexity CPT 97161 • Physical Therapy | $84 | $107 | $152 |