| Arthroscopy knee with meniscectomy CPT 29881 • Orthopedics | $697 | $869 | $1,280 |
| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $30 | $564 | $1,379 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $30 | $873 | $2,123 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $30 | $885 | $1,841 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $211 | $1,313 | $2,208 |
| Carpal tunnel release CPT 64721 • Orthopedics | $30 | $536 | $801 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $30 | $136 | $244 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $143 | $335 | $570 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $79 | $129 | $207 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $116 | $364 | $559 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $30 | $1,406 | $3,371 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $37 | $92 | $147 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $25 | $63 | $88 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $82 | $398 | $773 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $30 | $155 | $343 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $159 | $295 | $491 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $50 | $102 | $132 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $145 | $222 | $333 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $226 | $545 | $648 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $68 | $219 | $353 |
| Cytopathology concentration technique CPT 88108 • Pathology | $20 | $85 | $115 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $19 | $116 | $264 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $13 | $33 | $51 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $6 | $22 | $34 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $15 | $32 | $84 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $9 | $21 | $47 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $14 | $33 | $68 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $5 | $25 | $68 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $11 | $47 | $63 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $29 | $100 | $207 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $160 | $199 | $219 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $281 | $339 | $408 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $40 | $126 | $156 |
| Special stain group II CPT 88313 • Pathology | $24 | $95 | $114 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $27 | $64 | $134 |
| Frozen section pathology each additional CPT 88332 • Pathology | $20 | $31 | $41 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $26 | $115 | $153 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $16 | $133 | $184 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $36 | $114 | $168 |
| Microdissection manual CPT 88381 • Pathology | $65 | $179 | $333 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $0 | $6 | $9 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $7 | $13 | $17 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $9 | $13 | $16 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $12 | $16 | $20 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $8 | $16 | $20 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $20 | $41 | $63 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $21 | $52 | $80 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $18 | $41 | $70 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $18 | $34 | $59 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $11 | $34 | $43 |