| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $30 | $381 | $732 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $30 | $548 | $1,065 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $30 | $418 | $1,195 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $30 | $705 | $1,379 |
| Carpal tunnel release CPT 64721 • Orthopedics | $30 | $198 | $535 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $8 | $114 | $224 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $242 | $289 | $367 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $79 | $155 | $231 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $15 | $211 | $361 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $30 | $808 | $2,288 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $30 | $81 | $132 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $25 | $49 | $67 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $30 | $134 | $232 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $30 | $128 | $217 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $106 | $176 | $251 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $67 | $107 | $147 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $149 | $171 | $216 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $359 | $411 | $437 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $96 | $168 | $240 |
| Cytopathology concentration technique CPT 88108 • Pathology | $19 | $39 | $49 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $25 | $36 | $51 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $11 | $13 | $17 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $7 | $11 | $13 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $12 | $18 | $21 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $3 | $10 | $17 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $13 | $13 | $13 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $5 | $12 | $18 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $5 | $19 | $31 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $17 | $23 | $30 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $89 | $175 | $219 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $65 | $199 | $333 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $27 | $51 | $86 |
| Special stain group II CPT 88313 • Pathology | $29 | $38 | $61 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $31 | $36 | $41 |
| Frozen section pathology each additional CPT 88332 • Pathology | $14 | $28 | $41 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $11 | $44 | $68 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $21 | $50 | $77 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $52 | $57 | $60 |
| Microdissection manual CPT 88381 • Pathology | $73 | $116 | $159 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $5 | $5 | $5 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $10 | $12 | $15 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $8 | $11 | $15 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $12 | $14 | $17 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $10 | $11 | $13 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $22 | $25 | $27 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $25 | $27 | $28 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $20 | $23 | $25 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $19 | $22 | $26 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $14 | $14 | $15 |
| Physical therapy evaluation low complexity CPT 97161 • Physical Therapy | $75 | $79 | $83 |