| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $482 | $1,396 | $2,311 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $91 | $1,676 | $3,261 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $830 | $1,564 | $3,031 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $703 | $1,792 | $3,671 |
| Carpal tunnel release CPT 64721 • Orthopedics | $204 | $703 | $1,491 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $76 | $309 | $542 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $20 | $446 | $871 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $26 | $244 | $462 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $9 | $369 | $858 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $389 | $887 | $1,386 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $11 | $100 | $250 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $24 | $79 | $167 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $46 | $364 | $817 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $21 | $196 | $372 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $124 | $291 | $586 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $36 | $141 | $302 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $11 | $219 | $508 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $207 | $696 | $1,468 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $56 | $127 | $198 |
| Cytopathology concentration technique CPT 88108 • Pathology | $33 | $65 | $112 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $30 | $51 | $72 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $17 | $31 | $60 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $14 | $25 | $47 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $21 | $38 | $72 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $18 | $38 | $58 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $13 | $41 | $85 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $20 | $37 | $66 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $9 | $23 | $32 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $28 | $62 | $97 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $44 | $337 | $746 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $67 | $259 | $376 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $17 | $107 | $220 |
| Special stain group II CPT 88313 • Pathology | $53 | $98 | $178 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $40 | $72 | $105 |
| Frozen section pathology each additional CPT 88332 • Pathology | $24 | $69 | $143 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $44 | $86 | $149 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $50 | $72 | $91 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $32 | $66 | $109 |
| Microdissection manual CPT 88381 • Pathology | $19 | $78 | $153 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $4 | $7 | $14 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $8 | $15 | $27 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $8 | $14 | $26 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $10 | $17 | $32 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $10 | $17 | $32 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $20 | $35 | $65 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $23 | $41 | $75 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $20 | $35 | $65 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $19 | $33 | $60 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $12 | $21 | $39 |
| Physical therapy evaluation low complexity CPT 97161 • Physical Therapy | $35 | $109 | $223 |