| Open treatment tibial shaft fracture CPT 27756 • Orthopedics | $523 | $861 | $1,444 |
| Closed treatment distal fibula fracture CPT 27786 • Orthopedics | $225 | $504 | $803 |
| Bunionectomy with osteotomy CPT 28296 • Orthopedics | $424 | $1,208 | $2,749 |
| Arthroscopy shoulder decompression CPT 29826 • Orthopedics | $175 | $295 | $416 |
| Arthroscopy shoulder rotator cuff repair CPT 29827 • Orthopedics | $902 | $1,564 | $2,625 |
| Arthroscopy knee with meniscectomy medial and lateral CPT 29880 • Orthopedics | $567 | $877 | $1,395 |
| Arthroscopy knee with meniscectomy CPT 29881 • Orthopedics | $547 | $1,186 | $3,341 |
| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $563 | $1,028 | $1,700 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $796 | $1,399 | $2,399 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $774 | $2,266 | $7,449 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $893 | $1,602 | $2,735 |
| Carpal tunnel release CPT 64721 • Orthopedics | $338 | $644 | $1,113 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $69 | $311 | $1,019 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $89 | $322 | $679 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $65 | $139 | $351 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $83 | $312 | $671 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $640 | $2,059 | $6,196 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $59 | $106 | $191 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $34 | $78 | $121 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $92 | $393 | $920 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $50 | $126 | $286 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $76 | $224 | $459 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $50 | $107 | $227 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $124 | $252 | $386 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $178 | $721 | $1,468 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $56 | $204 | $643 |
| Unlisted nervous system procedure CPT 64999 • Pain Management | $0 | $0 | $0 |
| Cytopathology concentration technique CPT 88108 • Pathology | $10 | $55 | $101 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $39 | $68 | $98 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $13 | $36 | $61 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $6 | $19 | $40 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $15 | $36 | $67 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $15 | $30 | $54 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $14 | $55 | $90 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $7 | $40 | $83 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $19 | $57 | $94 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $48 | $86 | $105 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $23 | $390 | $711 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $112 | $509 | $903 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $15 | $151 | $278 |
| Special stain group II CPT 88313 • Pathology | $10 | $93 | $214 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $29 | $115 | $243 |
| Frozen section pathology each additional CPT 88332 • Pathology | $21 | $59 | $96 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $24 | $113 | $239 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $29 | $122 | $278 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $20 | $136 | $293 |
| Microdissection manual CPT 88381 • Pathology | $22 | $222 | $578 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $4 | $8 | $16 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $10 | $20 | $29 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $11 | $19 | $28 |