| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $41 | $1,062 | $3,209 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $41 | $1,199 | $3,121 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $41 | $1,211 | $3,551 |
| Carpal tunnel release CPT 64721 • Orthopedics | $41 | $372 | $1,367 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $41 | $202 | $523 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $103 | $235 | $364 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $80 | $172 | $291 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $10 | $312 | $782 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $30 | $1,170 | $4,242 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $38 | $108 | $257 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $43 | $72 | $157 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $41 | $152 | $375 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $41 | $102 | $285 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $159 | $207 | $304 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $47 | $122 | $282 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $123 | $207 | $456 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $408 | $495 | $747 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $173 | $290 | $569 |
| Cytopathology concentration technique CPT 88108 • Pathology | $50 | $70 | $128 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $32 | $70 | $89 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $25 | $27 | $30 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $13 | $13 | $14 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $31 | $34 | $37 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $3 | $13 | $20 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $30 | $43 | $56 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $28 | $41 | $48 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $9 | $10 | $11 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $31 | $54 | $93 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $204 | $226 | $272 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $145 | $248 | $300 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $27 | $72 | $94 |
| Special stain group II CPT 88313 • Pathology | $50 | $62 | $69 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $34 | $62 | $88 |
| Frozen section pathology each additional CPT 88332 • Pathology | $35 | $37 | $42 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $60 | $62 | $65 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $84 | $90 | $93 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $54 | $79 | $108 |
| Microdissection manual CPT 88381 • Pathology | $152 | $249 | $358 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $4 | $8 | $13 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $14 | $20 | $35 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $14 | $21 | $42 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $14 | $21 | $43 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $8 | $16 | $29 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $23 | $39 | $71 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $14 | $38 | $74 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $20 | $39 | $63 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $13 | $34 | $67 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $14 | $23 | $39 |
| Physical therapy evaluation low complexity CPT 97161 • Physical Therapy | $63 | $102 | $180 |
| Physical therapy evaluation moderate complexity CPT 97162 • Physical Therapy | $58 | $96 | $180 |