| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $30 | $1,171 | $2,311 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $30 | $1,646 | $3,261 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $30 | $1,531 | $3,031 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $1,660 | $2,666 | $3,671 |
| Carpal tunnel release CPT 64721 • Orthopedics | $62 | $777 | $1,491 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $13 | $278 | $542 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $357 | $364 | $372 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $14 | $238 | $462 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $366 | $612 | $858 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $44 | $3,821 | $7,598 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $30 | $140 | $250 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $73 | $120 | $167 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $243 | $530 | $817 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $110 | $241 | $372 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $171 | $378 | $586 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $80 | $191 | $302 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $83 | $295 | $508 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $333 | $487 | $641 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $27 | $414 | $800 |
| Cytopathology concentration technique CPT 88108 • Pathology | $19 | $66 | $112 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $8 | $90 | $173 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $3 | $31 | $60 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $4 | $26 | $47 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $7 | $40 | $72 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $12 | $35 | $58 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $19 | $52 | $85 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $4 | $35 | $66 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $12 | $46 | $80 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $21 | $103 | $185 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $34 | $124 | $214 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $176 | $464 | $752 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $13 | $151 | $289 |
| Special stain group II CPT 88313 • Pathology | $24 | $101 | $178 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $25 | $65 | $105 |
| Frozen section pathology each additional CPT 88332 • Pathology | $32 | $87 | $143 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $52 | $101 | $149 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $12 | $51 | $91 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $24 | $164 | $305 |
| Microdissection manual CPT 88381 • Pathology | $112 | $314 | $516 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $4 | $9 | $14 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $10 | $19 | $27 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $7 | $17 | $26 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $9 | $20 | $32 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $12 | $22 | $32 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $47 | $56 | $65 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $53 | $64 | $75 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $18 | $42 | $65 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $43 | $51 | $60 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $11 | $25 | $39 |
| Physical therapy evaluation low complexity CPT 97161 • Physical Therapy | $128 | $175 | $223 |