| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $135 | $463 | $674 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $44 | $353 | $824 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $664 | $763 | $817 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $44 | $629 | $924 |
| Carpal tunnel release CPT 64721 • Orthopedics | $212 | $320 | $385 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $17 | $110 | $179 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $79 | $185 | $262 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $72 | $110 | $136 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $15 | $153 | $233 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $39 | $661 | $1,557 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $30 | $46 | $63 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $31 | $38 | $43 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $49 | $155 | $222 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $44 | $46 | $48 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $66 | $121 | $155 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $44 | $64 | $80 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $124 | $128 | $130 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $188 | $299 | $399 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $48 | $146 | $248 |
| Cytopathology concentration technique CPT 88108 • Pathology | $25 | $31 | $37 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $20 | $42 | $65 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $13 | $17 | $25 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $6 | $11 | $15 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $7 | $19 | $27 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $17 | $19 | $21 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $4 | $21 | $33 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $19 | $20 | $22 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $19 | $24 | $28 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $38 | $41 | $44 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $219 | $242 | $265 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $113 | $131 | $149 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $54 | $66 | $74 |
| Special stain group II CPT 88313 • Pathology | $12 | $45 | $72 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $16 | $46 | $64 |
| Frozen section pathology each additional CPT 88332 • Pathology | $21 | $32 | $42 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $10 | $51 | $89 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $27 | $42 | $63 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $77 | $87 | $93 |
| Microdissection manual CPT 88381 • Pathology | $25 | $99 | $159 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $5 | $5 | $6 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $10 | $12 | $14 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $7 | $10 | $12 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $8 | $12 | $15 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $13 | $13 | $14 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $14 | $23 | $30 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $31 | $33 | $35 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $14 | $21 | $30 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $13 | $22 | $28 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $8 | $12 | $18 |
| Physical therapy evaluation low complexity CPT 97161 • Physical Therapy | $48 | $72 | $84 |