| Arthroscopy shoulder decompression CPT 29826 • Orthopedics | $23 | $299 | $734 |
| Arthroscopy shoulder rotator cuff repair CPT 29827 • Orthopedics | $42 | $1,429 | $3,133 |
| Arthroscopy knee with meniscectomy medial and lateral CPT 29880 • Orthopedics | $42 | $482 | $826 |
| Arthroscopy knee with meniscectomy CPT 29881 • Orthopedics | $42 | $680 | $1,589 |
| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $370 | $956 | $2,047 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $119 | $1,200 | $2,451 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $807 | $1,084 | $1,416 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $1,104 | $1,339 | $1,611 |
| Carpal tunnel release CPT 64721 • Orthopedics | $42 | $528 | $1,070 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $42 | $91 | $130 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $92 | $192 | $306 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $103 | $226 | $462 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $84 | $222 | $355 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $366 | $1,129 | $2,416 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $42 | $94 | $202 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $42 | $51 | $71 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $42 | $177 | $323 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $37 | $87 | $129 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $65 | $224 | $521 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $55 | $111 | $257 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $142 | $158 | $184 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $260 | $398 | $624 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $69 | $234 | $536 |
| Unlisted nervous system procedure CPT 64999 • Pain Management | $0 | $0 | $0 |
| Cytopathology concentration technique CPT 88108 • Pathology | $16 | $81 | $235 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $19 | $54 | $127 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $13 | $19 | $30 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $6 | $10 | $14 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $15 | $22 | $35 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $15 | $17 | $20 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $14 | $36 | $75 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $7 | $22 | $34 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $20 | $47 | $110 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $29 | $57 | $77 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $23 | $294 | $861 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $113 | $184 | $345 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $4 | $51 | $89 |
| Special stain group II CPT 88313 • Pathology | $12 | $64 | $164 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $40 | $86 | $176 |
| Frozen section pathology each additional CPT 88332 • Pathology | $13 | $31 | $43 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $11 | $48 | $77 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $16 | $96 | $263 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $20 | $57 | $95 |
| Microdissection manual CPT 88381 • Pathology | $20 | $149 | $405 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $3 | $5 | $7 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $7 | $12 | $19 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $7 | $13 | $23 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $9 | $14 | $23 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $8 | $11 | $16 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $18 | $26 | $39 |