| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $397 | $554 | $711 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $161 | $584 | $1,007 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $539 | $762 | $979 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $876 | $955 | $1,114 |
| Carpal tunnel release CPT 64721 • Orthopedics | $35 | $271 | $432 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $41 | $83 | $164 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $33 | $141 | $250 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $57 | $96 | $158 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $32 | $164 | $245 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $41 | $471 | $1,331 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $11 | $44 | $81 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $23 | $37 | $49 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $41 | $122 | $207 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $7 | $34 | $55 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $59 | $128 | $176 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $33 | $54 | $74 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $103 | $120 | $143 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $194 | $271 | $384 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $163 | $171 | $179 |
| Cytopathology concentration technique CPT 88108 • Pathology | $24 | $45 | $67 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $19 | $67 | $91 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $18 | $23 | $25 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $6 | $9 | $12 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $21 | $28 | $32 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $12 | $12 | $13 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $18 | $23 | $25 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $10 | $23 | $48 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $11 | $28 | $56 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $18 | $25 | $32 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $114 | $174 | $204 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $161 | $259 | $307 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $53 | $82 | $96 |
| Special stain group II CPT 88313 • Pathology | $7 | $46 | $70 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $37 | $44 | $52 |
| Frozen section pathology each additional CPT 88332 • Pathology | $18 | $26 | $35 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $12 | $33 | $61 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $18 | $43 | $93 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $42 | $44 | $46 |
| Microdissection manual CPT 88381 • Pathology | $91 | $126 | $166 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $3 | $4 | $6 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $10 | $12 | $15 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $14 | $16 | $18 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $13 | $15 | $19 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $12 | $14 | $14 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $21 | $25 | $31 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $14 | $23 | $32 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $14 | $20 | $28 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $20 | $23 | $29 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $14 | $15 | $17 |
| Physical therapy evaluation low complexity CPT 97161 • Physical Therapy | $60 | $66 | $78 |