| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $72 | $307 | $541 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $767 | $894 | $1,022 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $90 | $425 | $761 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $759 | $811 | $863 |
| Carpal tunnel release CPT 64721 • Orthopedics | $318 | $329 | $339 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $13 | $69 | $125 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $26 | $163 | $262 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $15 | $89 | $136 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $69 | $133 | $197 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $323 | $400 | $477 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $33 | $50 | $74 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $23 | $25 | $27 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $49 | $68 | $87 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $24 | $72 | $111 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $133 | $153 | $173 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $40 | $44 | $48 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $14 | $66 | $117 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $36 | $178 | $320 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $47 | $160 | $248 |
| Cytopathology concentration technique CPT 88108 • Pathology | $19 | $28 | $38 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $20 | $22 | $24 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $6 | $11 | $16 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $9 | $9 | $9 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $7 | $12 | $16 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $2 | $8 | $13 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $19 | $20 | $21 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $4 | $9 | $15 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $25 | $25 | $25 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $8 | $24 | $43 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $34 | $43 | $52 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $82 | $87 | $92 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $17 | $42 | $67 |
| Special stain group II CPT 88313 • Pathology | $8 | $28 | $48 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $35 | $48 | $60 |
| Frozen section pathology each additional CPT 88332 • Pathology | $17 | $18 | $19 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $37 | $38 | $39 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $20 | $42 | $64 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $50 | $64 | $71 |
| Microdissection manual CPT 88381 • Pathology | $94 | $115 | $126 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $3 | $4 | $6 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $7 | $9 | $13 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $7 | $8 | $11 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $8 | $10 | $13 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $8 | $10 | $13 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $18 | $21 | $27 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $21 | $24 | $31 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $18 | $21 | $26 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $16 | $19 | $25 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $10 | $12 | $16 |
| Physical therapy evaluation low complexity CPT 97161 • Physical Therapy | $31 | $53 | $75 |