| Discectomy lumbar single level CPT 63030 • Orthopedics | $139 | $1,345 | $2,834 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $697 | $1,702 | $3,216 |
| Carpal tunnel release CPT 64721 • Orthopedics | $559 | $711 | $1,062 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $49 | $190 | $412 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $100 | $210 | $335 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $108 | $229 | $462 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $92 | $292 | $623 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $550 | $1,832 | $3,424 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $56 | $104 | $202 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $33 | $55 | $101 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $69 | $301 | $663 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $76 | $112 | $147 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $89 | $218 | $443 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $60 | $128 | $257 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $150 | $237 | $416 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $189 | $426 | $657 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $54 | $245 | $536 |
| Cytopathology concentration technique CPT 88108 • Pathology | $20 | $82 | $235 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $22 | $77 | $127 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $12 | $37 | $92 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $6 | $11 | $16 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $15 | $21 | $29 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $12 | $18 | $27 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $14 | $35 | $75 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $7 | $20 | $34 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $11 | $55 | $110 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $29 | $69 | $99 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $80 | $372 | $861 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $131 | $360 | $753 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $29 | $77 | $137 |
| Special stain group II CPT 88313 • Pathology | $5 | $68 | $198 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $13 | $84 | $176 |
| Frozen section pathology each additional CPT 88332 • Pathology | $22 | $46 | $88 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $38 | $59 | $74 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $30 | $101 | $263 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $55 | $84 | $130 |
| Microdissection manual CPT 88381 • Pathology | $20 | $154 | $405 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $0 | $3 | $6 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $6 | $10 | $13 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $9 | $12 | $16 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $9 | $12 | $15 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $6 | $12 | $19 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $17 | $27 | $40 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $16 | $29 | $46 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $15 | $25 | $40 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $15 | $25 | $37 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $9 | $16 | $24 |
| Physical therapy evaluation low complexity CPT 97161 • Physical Therapy | $67 | $234 | $500 |
| Physical therapy evaluation moderate complexity CPT 97162 • Physical Therapy | $67 | $127 | $235 |
| Physical therapy evaluation high complexity CPT 97163 • Physical Therapy | $66 | $126 | $235 |