| Discectomy lumbar single level CPT 63030 • Orthopedics | $30 | $636 | $961 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $904 | $1,051 | $1,152 |
| Carpal tunnel release CPT 64721 • Orthopedics | $30 | $332 | $433 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $30 | $190 | $455 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $101 | $232 | $287 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $81 | $133 | $181 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $221 | $253 | $282 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $30 | $996 | $2,287 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $30 | $75 | $112 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $44 | $49 | $56 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $223 | $269 | $403 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $30 | $107 | $179 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $81 | $166 | $225 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $47 | $80 | $94 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $131 | $148 | $160 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $419 | $446 | $503 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $176 | $221 | $240 |
| Cytopathology concentration technique CPT 88108 • Pathology | $26 | $42 | $49 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $13 | $45 | $76 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $16 | $19 | $27 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $9 | $11 | $13 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $21 | $22 | $24 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $12 | $14 | $17 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $17 | $26 | $36 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $4 | $6 | $9 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $5 | $18 | $33 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $17 | $37 | $54 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $37 | $153 | $219 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $105 | $229 | $333 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $42 | $55 | $65 |
| Special stain group II CPT 88313 • Pathology | $5 | $38 | $62 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $17 | $54 | $79 |
| Frozen section pathology each additional CPT 88332 • Pathology | $6 | $16 | $23 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $13 | $39 | $68 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $16 | $52 | $77 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $32 | $58 | $93 |
| Microdissection manual CPT 88381 • Pathology | $63 | $114 | $140 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $3 | $5 | $5 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $10 | $11 | $12 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $9 | $10 | $14 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $11 | $12 | $15 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $9 | $11 | $12 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $20 | $23 | $26 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $21 | $25 | $28 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $18 | $22 | $25 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $19 | $21 | $24 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $13 | $14 | $17 |
| Physical therapy evaluation low complexity CPT 97161 • Physical Therapy | $59 | $75 | $83 |
| Physical therapy evaluation moderate complexity CPT 97162 • Physical Therapy | $59 | $76 | $84 |
| Physical therapy evaluation high complexity CPT 97163 • Physical Therapy | $59 | $73 | $83 |