| Arthroscopy knee with meniscectomy CPT 29881 • Orthopedics | $542 | $766 | $1,230 |
| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $411 | $830 | $1,557 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $147 | $1,103 | $2,184 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $592 | $1,140 | $2,138 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $168 | $1,238 | $2,582 |
| Carpal tunnel release CPT 64721 • Orthopedics | $419 | $592 | $1,014 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $49 | $169 | $357 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $100 | $261 | $564 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $86 | $169 | $298 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $92 | $277 | $555 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $429 | $1,524 | $4,826 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $39 | $93 | $161 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $46 | $59 | $106 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $71 | $283 | $530 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $52 | $123 | $220 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $91 | $207 | $387 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $51 | $96 | $197 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $126 | $201 | $351 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $232 | $490 | $944 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $59 | $186 | $512 |
| Cytopathology concentration technique CPT 88108 • Pathology | $20 | $51 | $124 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $22 | $68 | $146 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $12 | $25 | $54 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $6 | $9 | $15 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $15 | $23 | $38 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $12 | $16 | $30 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $14 | $33 | $72 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $23 | $40 | $74 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $15 | $41 | $93 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $21 | $54 | $153 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $46 | $200 | $624 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $81 | $309 | $927 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $11 | $74 | $244 |
| Special stain group II CPT 88313 • Pathology | $5 | $50 | $180 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $13 | $72 | $214 |
| Frozen section pathology each additional CPT 88332 • Pathology | $6 | $33 | $117 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $24 | $72 | $209 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $30 | $84 | $244 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $39 | $96 | $257 |
| Microdissection manual CPT 88381 • Pathology | $30 | $66 | $91 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $0 | $4 | $6 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $6 | $12 | $18 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $9 | $15 | $17 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $9 | $14 | $20 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $6 | $14 | $30 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $17 | $26 | $35 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $16 | $27 | $37 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $15 | $23 | $31 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $16 | $30 | $59 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $9 | $16 | $22 |