| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $601 | $746 | $897 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $854 | $1,090 | $1,287 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $817 | $954 | $1,229 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $929 | $1,168 | $1,406 |
| Carpal tunnel release CPT 64721 • Orthopedics | $368 | $424 | $535 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $38 | $146 | $232 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $100 | $227 | $351 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $80 | $150 | $220 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $144 | $200 | $227 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $38 | $765 | $1,891 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $60 | $95 | $133 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $43 | $52 | $68 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $220 | $284 | $348 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $92 | $95 | $97 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $126 | $143 | $159 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $79 | $91 | $115 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $123 | $150 | $204 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $408 | $489 | $651 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $173 | $206 | $273 |
| Cytopathology concentration technique CPT 88108 • Pathology | $42 | $58 | $66 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $25 | $57 | $89 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $16 | $21 | $25 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $9 | $9 | $9 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $22 | $28 | $31 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $12 | $14 | $15 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $17 | $17 | $17 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $4 | $17 | $30 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $29 | $42 | $55 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $22 | $46 | $70 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $48 | $99 | $125 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $188 | $244 | $300 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $42 | $68 | $94 |
| Special stain group II CPT 88313 • Pathology | $7 | $48 | $69 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $53 | $64 | $79 |
| Frozen section pathology each additional CPT 88332 • Pathology | $18 | $26 | $35 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $27 | $49 | $60 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $25 | $50 | $91 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $32 | $57 | $108 |
| Microdissection manual CPT 88381 • Pathology | $34 | $34 | $34 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $4 | $4 | $5 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $11 | $13 | $14 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $13 | $15 | $16 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $14 | $15 | $17 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $12 | $14 | $14 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $23 | $26 | $29 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $27 | $28 | $30 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $14 | $20 | $25 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $25 | $26 | $27 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $18 | $18 | $18 |
| Physical therapy evaluation low complexity CPT 97161 • Physical Therapy | $63 | $72 | $81 |