| Carpal tunnel release CPT 64721 • Orthopedics | $403 | $599 | $882 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $94 | $226 | $371 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $129 | $279 | $458 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $103 | $231 | $379 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $118 | $323 | $451 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $419 | $1,790 | $4,692 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $71 | $99 | $132 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $37 | $60 | $73 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $141 | $289 | $553 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $88 | $182 | $276 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $125 | $272 | $402 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $87 | $143 | $204 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $142 | $222 | $309 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $260 | $554 | $985 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $69 | $314 | $601 |
| Unlisted nervous system procedure CPT 64999 • Pain Management | $830 | $858 | $886 |
| Cytopathology concentration technique CPT 88108 • Pathology | $14 | $58 | $91 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $25 | $62 | $111 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $11 | $29 | $44 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $7 | $21 | $35 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $18 | $38 | $52 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $10 | $27 | $42 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $13 | $32 | $60 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $18 | $38 | $59 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $28 | $50 | $76 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $18 | $64 | $107 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $89 | $278 | $511 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $134 | $387 | $762 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $37 | $89 | $165 |
| Special stain group II CPT 88313 • Pathology | $20 | $76 | $133 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $12 | $60 | $87 |
| Frozen section pathology each additional CPT 88332 • Pathology | $14 | $45 | $97 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $11 | $81 | $142 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $21 | $99 | $165 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $26 | $85 | $149 |
| Microdissection manual CPT 88381 • Pathology | $26 | $153 | $323 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $1 | $6 | $12 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $1 | $15 | $29 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $1 | $14 | $21 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $1 | $17 | $33 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $1 | $14 | $25 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $1 | $30 | $52 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $1 | $32 | $58 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $1 | $27 | $52 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $1 | $28 | $49 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $1 | $18 | $32 |
| Physical therapy evaluation low complexity CPT 97161 • Physical Therapy | $80 | $179 | $500 |
| Physical therapy evaluation moderate complexity CPT 97162 • Physical Therapy | $1 | $96 | $177 |
| Physical therapy evaluation high complexity CPT 97163 • Physical Therapy | $1 | $96 | $177 |
| Physical therapy re-evaluation CPT 97164 • Physical Therapy | $1 | $60 | $123 |