| Arthroscopy shoulder decompression CPT 29826 • Orthopedics | $26 | $502 | $1,128 |
| Arthroscopy shoulder rotator cuff repair CPT 29827 • Orthopedics | $149 | $1,759 | $3,487 |
| Arthroscopy knee with meniscectomy medial and lateral CPT 29880 • Orthopedics | $381 | $1,169 | $2,546 |
| Arthroscopy knee with meniscectomy CPT 29881 • Orthopedics | $577 | $1,183 | $2,122 |
| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $423 | $1,144 | $2,267 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $949 | $1,998 | $3,821 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $904 | $1,886 | $3,121 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $169 | $2,043 | $3,694 |
| Carpal tunnel release CPT 64721 • Orthopedics | $251 | $763 | $1,376 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $83 | $294 | $523 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $108 | $416 | $797 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $98 | $370 | $990 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $98 | $426 | $782 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $263 | $1,901 | $4,242 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $49 | $107 | $257 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $48 | $81 | $157 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $92 | $288 | $713 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $59 | $145 | $285 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $74 | $296 | $561 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $63 | $151 | $282 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $128 | $271 | $456 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $216 | $739 | $1,376 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $68 | $290 | $569 |
| Unlisted nervous system procedure CPT 64999 • Pain Management | $0 | $0 | $0 |
| Cytopathology concentration technique CPT 88108 • Pathology | $21 | $51 | $106 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $22 | $55 | $127 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $13 | $28 | $39 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $6 | $14 | $23 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $15 | $37 | $62 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $18 | $24 | $34 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $14 | $33 | $44 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $7 | $25 | $71 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $15 | $35 | $55 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $16 | $55 | $92 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $23 | $189 | $371 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $112 | $251 | $554 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $23 | $48 | $96 |
| Special stain group II CPT 88313 • Pathology | $12 | $55 | $113 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $34 | $74 | $166 |
| Frozen section pathology each additional CPT 88332 • Pathology | $12 | $39 | $84 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $11 | $62 | $98 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $30 | $46 | $84 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $51 | $96 | $237 |
| Microdissection manual CPT 88381 • Pathology | $29 | $129 | $236 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $4 | $8 | $13 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $10 | $23 | $35 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $8 | $23 | $42 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $10 | $26 | $43 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $9 | $20 | $29 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $22 | $45 | $71 |