| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $1,101 | $1,424 | $1,747 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $1,016 | $1,260 | $1,446 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $1,173 | $1,464 | $1,715 |
| Carpal tunnel release CPT 64721 • Orthopedics | $455 | $574 | $693 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $76 | $103 | $130 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $142 | $259 | $376 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $114 | $175 | $236 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $130 | $250 | $369 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $474 | $531 | $587 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $100 | $106 | $112 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $61 | $67 | $73 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $120 | $246 | $372 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $184 | $187 | $190 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $201 | $221 | $240 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $66 | $72 | $78 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $183 | $201 | $218 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $306 | $575 | $723 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $97 | $170 | $242 |
| Cytopathology concentration technique CPT 88108 • Pathology | $19 | $22 | $26 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $25 | $42 | $59 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $11 | $14 | $16 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $7 | $8 | $9 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $5 | $14 | $22 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $5 | $9 | $12 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $13 | $15 | $17 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $3 | $4 | $4 |
| 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 | $18 | $20 | $22 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $48 | $226 | $580 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $65 | $74 | $83 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $16 | $21 | $27 |
| Special stain group II CPT 88313 • Pathology | $6 | $69 | $166 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $12 | $14 | $17 |
| Frozen section pathology each additional CPT 88332 • Pathology | $14 | $19 | $24 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $11 | $78 | $183 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $21 | $86 | $214 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $32 | $42 | $52 |
| Microdissection manual CPT 88381 • Pathology | $99 | $106 | $114 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $4 | $6 | $10 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $5 | $9 | $14 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $11 | $14 | $16 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $12 | $14 | $17 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $9 | $11 | $12 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $22 | $33 | $49 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $23 | $26 | $30 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $19 | $22 | $25 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $20 | $30 | $42 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $14 | $16 | $18 |
| Physical therapy evaluation low complexity CPT 97161 • Physical Therapy | $70 | $106 | $166 |
| Physical therapy evaluation moderate complexity CPT 97162 • Physical Therapy | $70 | $106 | $166 |