| Arthroscopy knee with meniscectomy CPT 29881 • Orthopedics | $377 | $803 | $1,589 |
| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $435 | $1,017 | $2,047 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $880 | $1,637 | $2,451 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $133 | $837 | $1,358 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $174 | $954 | $1,538 |
| Carpal tunnel release CPT 64721 • Orthopedics | $381 | $671 | $1,070 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $72 | $139 | $232 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $108 | $246 | $379 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $120 | $229 | $462 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $98 | $246 | $374 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $388 | $1,553 | $3,168 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $50 | $106 | $202 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $28 | $47 | $68 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $95 | $228 | $349 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $44 | $106 | $157 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $74 | $249 | $521 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $65 | $132 | $257 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $132 | $170 | $213 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $324 | $419 | $591 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $87 | $270 | $536 |
| Unlisted nervous system procedure CPT 64999 • Pain Management | $0 | $0 | $0 |
| Cytopathology concentration technique CPT 88108 • Pathology | $16 | $89 | $235 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $18 | $42 | $54 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $13 | $25 | $52 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $6 | $12 | $21 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $19 | $26 | $37 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $15 | $22 | $29 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $14 | $40 | $75 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $5 | $18 | $34 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $16 | $49 | $110 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $29 | $49 | $59 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $110 | $369 | $861 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $116 | $261 | $403 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $4 | $73 | $118 |
| Special stain group II CPT 88313 • Pathology | $3 | $42 | $95 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $16 | $82 | $176 |
| Frozen section pathology each additional CPT 88332 • Pathology | $13 | $42 | $74 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $11 | $58 | $89 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $46 | $120 | $263 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $33 | $73 | $113 |
| Microdissection manual CPT 88381 • Pathology | $163 | $259 | $405 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $4 | $6 | $9 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $8 | $12 | $19 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $8 | $15 | $24 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $10 | $13 | $21 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $9 | $12 | $20 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $20 | $28 | $42 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $23 | $35 | $48 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $20 | $26 | $42 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $18 | $25 | $38 |