| Total knee replacement CPT 27447 • Orthopedics | $1,253 | $1,483 | $1,713 |
| Open treatment tibial shaft fracture CPT 27756 • Orthopedics | $622 | $622 | $622 |
| Closed treatment distal fibula fracture CPT 27786 • Orthopedics | $328 | $328 | $328 |
| Bunionectomy with osteotomy CPT 28296 • Orthopedics | $805 | $805 | $805 |
| Arthroscopy shoulder decompression CPT 29826 • Orthopedics | $169 | $458 | $747 |
| Arthroscopy shoulder rotator cuff repair CPT 29827 • Orthopedics | $1,045 | $1,132 | $1,219 |
| Arthroscopy knee with meniscectomy medial and lateral CPT 29880 • Orthopedics | $550 | $651 | $752 |
| Arthroscopy knee with meniscectomy CPT 29881 • Orthopedics | $529 | $615 | $700 |
| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $756 | $756 | $756 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $956 | $1,028 | $1,101 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $1,016 | $1,016 | $1,016 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $1,173 | $1,173 | $1,173 |
| Carpal tunnel release CPT 64721 • Orthopedics | $433 | $444 | $455 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $76 | $117 | $158 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $142 | $142 | $142 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $114 | $114 | $114 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $130 | $192 | $254 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $474 | $474 | $474 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $74 | $93 | $112 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $48 | $54 | $61 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $120 | $181 | $242 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $110 | $147 | $184 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $170 | $186 | $201 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $66 | $77 | $88 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $183 | $183 | $183 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $306 | $306 | $306 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $242 | $242 | $242 |
| Cytopathology concentration technique CPT 88108 • Pathology | $19 | $19 | $19 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $25 | $25 | $25 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $11 | $11 | $11 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $7 | $7 | $7 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $5 | $5 | $5 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $5 | $5 | $5 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $13 | $13 | $13 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $3 | $3 | $3 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $5 | $5 | $5 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $18 | $18 | $18 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $51 | $51 | $51 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $65 | $65 | $65 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $27 | $27 | $27 |
| Special stain group II CPT 88313 • Pathology | $6 | $6 | $6 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $12 | $12 | $12 |
| Frozen section pathology each additional CPT 88332 • Pathology | $14 | $14 | $14 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $11 | $11 | $11 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $21 | $21 | $21 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $52 | $72 | $92 |
| Microdissection manual CPT 88381 • Pathology | $99 | $129 | $159 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $4 | $4 | $5 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $5 | $8 | $10 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $9 | $10 | $11 |