| Arthroscopy shoulder decompression CPT 29826 • Orthopedics | $127 | $173 | $219 |
| Arthroscopy shoulder rotator cuff repair CPT 29827 • Orthopedics | $105 | $142 | $179 |
| Arthroscopy knee with meniscectomy medial and lateral CPT 29880 • Orthopedics | $348 | $348 | $348 |
| Arthroscopy knee with meniscectomy CPT 29881 • Orthopedics | $530 | $600 | $671 |
| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $30 | $231 | $433 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $30 | $627 | $1,223 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $30 | $111 | $192 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $1,360 | $1,360 | $1,360 |
| Carpal tunnel release CPT 64721 • Orthopedics | $30 | $412 | $795 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $30 | $94 | $157 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $258 | $285 | $311 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $49 | $87 | $125 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $284 | $401 | $519 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $6 | $31 | $56 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $49 | $49 | $49 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $418 | $418 | $418 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $30 | $48 | $66 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $319 | $319 | $319 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $67 | $115 | $162 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $129 | $139 | $150 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $437 | $473 | $510 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $209 | $225 | $240 |
| Cytopathology concentration technique CPT 88108 • Pathology | $29 | $39 | $49 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $46 | $46 | $46 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $39 | $39 | $39 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $13 | $13 | $13 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $21 | $21 | $21 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $3 | $3 | $3 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $41 | $41 | $41 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $9 | $9 | $9 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $34 | $34 | $34 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $36 | $36 | $36 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $107 | $163 | $219 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $190 | $190 | $190 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $34 | $34 | $34 |
| Special stain group II CPT 88313 • Pathology | $12 | $14 | $16 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $31 | $56 | $81 |
| Frozen section pathology each additional CPT 88332 • Pathology | $40 | $40 | $40 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $37 | $52 | $68 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $15 | $31 | $46 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $55 | $57 | $60 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $5 | $5 | $5 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $10 | $14 | $18 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $10 | $12 | $14 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $12 | $12 | $12 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $12 | $14 | $15 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $38 | $38 | $38 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $44 | $44 | $44 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $25 | $29 | $34 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $31 | $31 | $31 |