| Arthroscopy knee with meniscectomy CPT 29881 • Orthopedics | $769 | $932 | $1,014 |
| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $674 | $867 | $1,094 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $956 | $1,273 | $1,594 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $1,108 | $1,351 | $1,472 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $1,319 | $1,509 | $1,698 |
| Carpal tunnel release CPT 64721 • Orthopedics | $496 | $605 | $659 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $90 | $195 | $335 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $105 | $233 | $337 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $108 | $115 | $123 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $141 | $217 | $255 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $511 | $511 | $511 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $92 | $127 | $163 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $49 | $54 | $66 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $473 | $515 | $556 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $51 | $135 | $267 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $105 | $138 | $171 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $89 | $110 | $153 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $150 | $166 | $198 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $344 | $469 | $626 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $183 | $209 | $261 |
| Cytopathology concentration technique CPT 88108 • Pathology | $21 | $34 | $47 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $38 | $43 | $48 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $13 | $27 | $40 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $9 | $11 | $13 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $22 | $51 | $66 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $12 | $12 | $12 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $16 | $20 | $24 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $23 | $24 | $25 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $26 | $28 | $30 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $58 | $58 | $58 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $53 | $154 | $207 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $73 | $194 | $314 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $27 | $54 | $80 |
| Special stain group II CPT 88313 • Pathology | $8 | $32 | $57 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $28 | $40 | $51 |
| Frozen section pathology each additional CPT 88332 • Pathology | $19 | $29 | $40 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $27 | $44 | $61 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $27 | $50 | $72 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $27 | $40 | $53 |
| Microdissection manual CPT 88381 • Pathology | $31 | $87 | $142 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $4 | $4 | $5 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $8 | $10 | $12 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $7 | $9 | $11 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $9 | $11 | $13 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $9 | $9 | $10 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $32 | $39 | $46 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $22 | $28 | $34 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $19 | $24 | $29 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $18 | $24 | $30 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $11 | $16 | $20 |