| Discectomy lumbar single level CPT 63030 • Orthopedics | $1,020 | $1,596 | $2,451 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $1,156 | $1,706 | $2,290 |
| Carpal tunnel release CPT 64721 • Orthopedics | $559 | $815 | $1,070 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $72 | $265 | $617 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $106 | $305 | $465 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $78 | $442 | $990 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $98 | $305 | $458 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $388 | $1,381 | $4,118 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $56 | $124 | $202 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $34 | $60 | $88 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $146 | $276 | $437 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $69 | $124 | $202 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $201 | $320 | $521 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $125 | $207 | $288 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $124 | $191 | $270 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $178 | $497 | $786 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $56 | $313 | $536 |
| Cytopathology concentration technique CPT 88108 • Pathology | $30 | $101 | $235 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $18 | $80 | $127 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $17 | $30 | $50 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $11 | $16 | $24 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $19 | $23 | $30 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $15 | $24 | $29 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $30 | $51 | $75 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $17 | $26 | $34 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $44 | $61 | $110 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $29 | $49 | $75 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $169 | $387 | $861 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $131 | $260 | $458 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $53 | $111 | $190 |
| Special stain group II CPT 88313 • Pathology | $8 | $31 | $85 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $74 | $128 | $176 |
| Frozen section pathology each additional CPT 88332 • Pathology | $36 | $51 | $74 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $24 | $68 | $93 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $12 | $105 | $263 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $33 | $85 | $127 |
| Microdissection manual CPT 88381 • Pathology | $52 | $224 | $405 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $4 | $6 | $7 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $11 | $14 | $18 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $11 | $14 | $17 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $10 | $15 | $22 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $10 | $12 | $16 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $27 | $34 | $43 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $26 | $34 | $50 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $17 | $24 | $34 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $25 | $32 | $40 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $11 | $16 | $21 |
| Physical therapy evaluation low complexity CPT 97161 • Physical Therapy | $74 | $136 | $235 |
| Physical therapy evaluation moderate complexity CPT 97162 • Physical Therapy | $74 | $136 | $235 |
| Physical therapy evaluation high complexity CPT 97163 • Physical Therapy | $79 | $137 | $235 |