| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $920 | $1,155 | $1,273 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $878 | $1,118 | $1,238 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $1,004 | $1,273 | $1,408 |
| Carpal tunnel release CPT 64721 • Orthopedics | $382 | $491 | $545 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $111 | $161 | $207 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $250 | $250 | $250 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $157 | $157 | $157 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $246 | $246 | $246 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $1,351 | $1,572 | $1,682 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $60 | $86 | $102 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $38 | $54 | $62 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $248 | $271 | $283 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $113 | $118 | $127 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $90 | $178 | $223 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $52 | $92 | $112 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $145 | $169 | $181 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $465 | $519 | $546 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $195 | $215 | $226 |
| Cytopathology concentration technique CPT 88108 • Pathology | $30 | $34 | $42 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $59 | $70 | $75 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $16 | $16 | $16 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $5 | $6 | $9 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $22 | $23 | $24 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $12 | $13 | $14 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $4 | $8 | $17 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $19 | $21 | $24 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $21 | $24 | $29 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $22 | $30 | $46 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $48 | $78 | $93 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $105 | $123 | $132 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $31 | $40 | $58 |
| Special stain group II CPT 88313 • Pathology | $31 | $35 | $42 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $9 | $33 | $53 |
| Frozen section pathology each additional CPT 88332 • Pathology | $6 | $20 | $26 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $13 | $30 | $38 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $25 | $42 | $50 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $39 | $59 | $70 |
| Microdissection manual CPT 88381 • Pathology | $80 | $113 | $129 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $5 | $5 | $5 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $14 | $14 | $14 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $16 | $16 | $16 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $17 | $17 | $17 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $12 | $12 | $12 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $29 | $29 | $29 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $30 | $30 | $30 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $25 | $25 | $25 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $27 | $27 | $27 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $18 | $18 | $18 |
| Physical therapy evaluation low complexity CPT 97161 • Physical Therapy | $81 | $81 | $81 |
| Physical therapy evaluation moderate complexity CPT 97162 • Physical Therapy | $81 | $81 | $81 |