| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $38 | $678 | $1,054 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $38 | $692 | $1,022 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $817 | $866 | $1,014 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $929 | $1,169 | $1,666 |
| Carpal tunnel release CPT 64721 • Orthopedics | $368 | $480 | $673 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $110 | $149 | $169 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $231 | $241 | $266 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $80 | $126 | $154 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $91 | $180 | $227 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $38 | $413 | $921 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $38 | $57 | $92 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $43 | $45 | $50 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $220 | $253 | $348 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $54 | $105 | $183 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $159 | $166 | $178 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $47 | $85 | $127 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $123 | $162 | $238 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $408 | $440 | $551 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $62 | $175 | $295 |
| Cytopathology concentration technique CPT 88108 • Pathology | $63 | $65 | $66 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $31 | $56 | $89 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $11 | $20 | $26 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $12 | $13 | $15 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $12 | $24 | $31 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $17 | $18 | $21 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $25 | $28 | $35 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $7 | $34 | $47 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $19 | $36 | $55 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $17 | $55 | $93 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $87 | $171 | $199 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $153 | $251 | $300 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $39 | $75 | $107 |
| Special stain group II CPT 88313 • Pathology | $32 | $58 | $77 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $51 | $69 | $79 |
| Frozen section pathology each additional CPT 88332 • Pathology | $32 | $34 | $35 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $31 | $53 | $65 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $35 | $78 | $107 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $63 | $91 | $108 |
| Microdissection manual CPT 88381 • Pathology | $140 | $146 | $157 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $4 | $4 | $6 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $12 | $13 | $14 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $11 | $15 | $17 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $13 | $14 | $14 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $10 | $12 | $14 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $22 | $27 | $42 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $24 | $30 | $47 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $14 | $20 | $26 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $19 | $25 | $40 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $14 | $14 | $16 |
| Physical therapy evaluation low complexity CPT 97161 • Physical Therapy | $63 | $86 | $155 |