| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $44 | $1,419 | $2,243 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $944 | $1,770 | $2,181 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $1,124 | $2,056 | $2,481 |
| Carpal tunnel release CPT 64721 • Orthopedics | $457 | $787 | $961 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $38 | $191 | $377 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $113 | $361 | $557 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $159 | $278 | $351 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $105 | $300 | $504 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $55 | $1,446 | $2,965 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $21 | $97 | $166 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $41 | $83 | $110 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $109 | $378 | $570 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $49 | $165 | $272 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $143 | $311 | $392 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $81 | $145 | $197 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $139 | $260 | $318 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $304 | $701 | $963 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $94 | $275 | $395 |
| Cytopathology concentration technique CPT 88108 • Pathology | $22 | $97 | $129 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $16 | $81 | $140 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $14 | $45 | $68 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $14 | $14 | $14 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $13 | $24 | $35 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $20 | $20 | $20 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $30 | $58 | $77 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $7 | $37 | $63 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $11 | $49 | $84 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $19 | $73 | $143 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $82 | $379 | $614 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $230 | $545 | $840 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $44 | $134 | $202 |
| Special stain group II CPT 88313 • Pathology | $37 | $83 | $142 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $24 | $102 | $203 |
| Frozen section pathology each additional CPT 88332 • Pathology | $12 | $62 | $110 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $36 | $121 | $187 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $42 | $126 | $220 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $64 | $128 | $289 |
| Microdissection manual CPT 88381 • Pathology | $152 | $152 | $152 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $6 | $8 | $12 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $12 | $22 | $33 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $8 | $25 | $40 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $13 | $28 | $45 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $13 | $20 | $27 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $21 | $48 | $68 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $27 | $45 | $71 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $24 | $46 | $67 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $6 | $36 | $63 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $17 | $17 | $18 |
| Physical therapy evaluation low complexity CPT 97161 • Physical Therapy | $83 | $128 | $170 |
| Physical therapy evaluation moderate complexity CPT 97162 • Physical Therapy | $73 | $119 | $170 |