| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $563 | $786 | $1,009 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $811 | $1,119 | $1,427 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $141 | $774 | $1,378 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $1,671 | $1,671 | $1,671 |
| Carpal tunnel release CPT 64721 • Orthopedics | $333 | $502 | $638 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $9 | $125 | $248 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $211 | $278 | $363 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $114 | $114 | $114 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $18 | $139 | $257 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $40 | $1,569 | $3,097 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $40 | $62 | $106 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $40 | $56 | $71 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $232 | $287 | $341 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $74 | $97 | $111 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $225 | $236 | $247 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $69 | $93 | $136 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $123 | $161 | $229 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $375 | $548 | $657 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $156 | $240 | $328 |
| Cytopathology concentration technique CPT 88108 • Pathology | $13 | $29 | $44 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $13 | $18 | $23 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $14 | $14 | $14 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $10 | $10 | $11 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $16 | $20 | $23 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $13 | $13 | $13 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $20 | $20 | $20 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $15 | $15 | $15 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $5 | $6 | $7 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $16 | $21 | $26 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $37 | $95 | $129 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $82 | $82 | $82 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $64 | $64 | $64 |
| Special stain group II CPT 88313 • Pathology | $5 | $35 | $52 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $11 | $34 | $55 |
| Frozen section pathology each additional CPT 88332 • Pathology | $32 | $32 | $32 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $13 | $31 | $43 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $12 | $30 | $61 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $34 | $39 | $45 |
| Microdissection manual CPT 88381 • Pathology | $115 | $117 | $119 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $3 | $4 | $6 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $8 | $10 | $12 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $8 | $9 | $10 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $9 | $11 | $13 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $7 | $9 | $12 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $16 | $21 | $26 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $17 | $23 | $30 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $14 | $19 | $26 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $15 | $19 | $24 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $10 | $13 | $16 |
| Physical therapy evaluation low complexity CPT 97161 • Physical Therapy | $76 | $82 | $88 |