| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $30 | $383 | $786 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $30 | $523 | $1,115 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $30 | $1,155 | $1,748 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $1,244 | $1,783 | $2,053 |
| Carpal tunnel release CPT 64721 • Orthopedics | $30 | $624 | $986 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $41 | $101 | $181 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $124 | $291 | $586 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $82 | $134 | $168 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $49 | $331 | $580 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $723 | $1,460 | $2,288 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $21 | $47 | $86 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $40 | $73 | $101 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $41 | $115 | $264 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $30 | $57 | $117 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $194 | $332 | $401 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $49 | $137 | $200 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $138 | $227 | $309 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $254 | $662 | $984 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $181 | $312 | $539 |
| Cytopathology concentration technique CPT 88108 • Pathology | $36 | $43 | $49 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $39 | $39 | $39 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $15 | $23 | $27 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $9 | $11 | $13 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $16 | $19 | $21 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $13 | $33 | $41 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $20 | $20 | $20 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $18 | $18 | $18 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $7 | $9 | $10 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $18 | $76 | $147 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $109 | $195 | $226 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $89 | $456 | $640 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $44 | $86 | $108 |
| Special stain group II CPT 88313 • Pathology | $7 | $61 | $79 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $16 | $82 | $166 |
| Frozen section pathology each additional CPT 88332 • Pathology | $11 | $18 | $32 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $36 | $58 | $68 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $15 | $61 | $103 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $26 | $129 | $229 |
| Microdissection manual CPT 88381 • Pathology | $103 | $103 | $103 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $5 | $6 | $7 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $10 | $13 | $14 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $10 | $19 | $27 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $12 | $13 | $14 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $12 | $13 | $14 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $27 | $49 | $60 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $14 | $20 | $31 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $19 | $27 | $36 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $13 | $32 | $57 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $16 | $16 | $16 |
| Physical therapy evaluation low complexity CPT 97161 • Physical Therapy | $58 | $64 | $76 |