| Arthroscopy knee with meniscectomy CPT 29881 • Orthopedics | $377 | $1,298 | $3,341 |
| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $435 | $1,039 | $1,767 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $160 | $1,113 | $2,477 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $133 | $2,674 | $7,449 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $174 | $1,607 | $2,803 |
| Carpal tunnel release CPT 64721 • Orthopedics | $259 | $573 | $1,159 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $83 | $244 | $421 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $162 | $475 | $666 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $129 | $355 | $878 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $104 | $364 | $655 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $271 | $1,900 | $5,692 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $34 | $94 | $189 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $33 | $69 | $110 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $60 | $291 | $626 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $28 | $341 | $716 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $77 | $216 | $455 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $65 | $186 | $395 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $171 | $254 | $382 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $216 | $583 | $1,066 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $55 | $534 | $1,600 |
| Unlisted nervous system procedure CPT 64999 • Pain Management | $0 | $0 | $0 |
| Cytopathology concentration technique CPT 88108 • Pathology | $16 | $55 | $157 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $41 | $74 | $127 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $13 | $40 | $71 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $6 | $18 | $47 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $15 | $36 | $68 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $15 | $31 | $55 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $14 | $45 | $87 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $5 | $36 | $86 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $9 | $45 | $83 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $48 | $61 | $93 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $23 | $282 | $743 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $34 | $328 | $754 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $15 | $57 | $130 |
| Special stain group II CPT 88313 • Pathology | $3 | $31 | $91 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $16 | $113 | $258 |
| Frozen section pathology each additional CPT 88332 • Pathology | $21 | $54 | $84 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $37 | $77 | $110 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $16 | $53 | $85 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $20 | $129 | $308 |
| Microdissection manual CPT 88381 • Pathology | $52 | $132 | $334 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $4 | $7 | $17 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $10 | $19 | $32 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $10 | $19 | $31 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $10 | $21 | $37 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $9 | $17 | $37 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $22 | $38 | $76 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $22 | $42 | $84 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $17 | $36 | $76 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $21 | $37 | $71 |