| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $839 | $2,053 | $3,267 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $1,507 | $1,520 | $1,533 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $30 | $565 | $1,100 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $30 | $681 | $1,332 |
| Carpal tunnel release CPT 64721 • Orthopedics | $30 | $281 | $532 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $197 | $203 | $210 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $130 | $273 | $345 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $197 | $218 | $240 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $360 | $368 | $376 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $1,945 | $2,352 | $2,758 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $91 | $91 | $91 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $54 | $61 | $67 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $30 | $163 | $297 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $135 | $135 | $135 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $213 | $227 | $242 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $80 | $102 | $124 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $147 | $174 | $202 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $573 | $824 | $1,264 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $290 | $488 | $686 |
| Cytopathology concentration technique CPT 88108 • Pathology | $51 | $72 | $93 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $22 | $39 | $55 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $18 | $34 | $50 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $10 | $12 | $13 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $23 | $36 | $49 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $13 | $16 | $19 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $28 | $39 | $51 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $11 | $18 | $25 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $24 | $29 | $34 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $20 | $54 | $88 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $47 | $162 | $234 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $358 | $487 | $615 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $91 | $120 | $149 |
| Special stain group II CPT 88313 • Pathology | $19 | $42 | $65 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $150 | $150 | $150 |
| Frozen section pathology each additional CPT 88332 • Pathology | $18 | $31 | $45 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $16 | $46 | $76 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $37 | $62 | $86 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $65 | $135 | $205 |
| Microdissection manual CPT 88381 • Pathology | $163 | $175 | $187 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $3 | $5 | $8 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $9 | $12 | $15 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $7 | $13 | $19 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $9 | $13 | $18 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $9 | $13 | $16 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $19 | $28 | $36 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $22 | $32 | $43 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $19 | $28 | $36 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $18 | $26 | $33 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $11 | $17 | $22 |
| Physical therapy evaluation low complexity CPT 97161 • Physical Therapy | $66 | $84 | $103 |