| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $30 | $541 | $919 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $30 | $773 | $1,332 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $949 | $1,103 | $1,204 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $1,311 | $1,383 | $1,454 |
| Carpal tunnel release CPT 64721 • Orthopedics | $433 | $514 | $596 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $111 | $217 | $380 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $294 | $298 | $302 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $200 | $214 | $228 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $268 | $498 | $729 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $2,188 | $2,225 | $2,262 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $30 | $58 | $89 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $49 | $58 | $67 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $326 | $451 | $576 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $69 | $120 | $181 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $114 | $174 | $235 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $89 | $110 | $121 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $150 | $248 | $394 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $481 | $530 | $584 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $216 | $304 | $456 |
| Cytopathology concentration technique CPT 88108 • Pathology | $23 | $59 | $94 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $67 | $78 | $90 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $26 | $29 | $33 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $15 | $15 | $15 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $38 | $50 | $76 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $18 | $20 | $21 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $63 | $63 | $63 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $30 | $38 | $46 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $40 | $49 | $57 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $46 | $65 | $83 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $176 | $312 | $380 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $152 | $387 | $622 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $59 | $109 | $159 |
| Special stain group II CPT 88313 • Pathology | $11 | $63 | $115 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $79 | $88 | $98 |
| Frozen section pathology each additional CPT 88332 • Pathology | $79 | $82 | $86 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $21 | $72 | $123 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $89 | $115 | $142 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $99 | $172 | $245 |
| Microdissection manual CPT 88381 • Pathology | $133 | $151 | $169 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $4 | $8 | $11 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $11 | $11 | $12 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $10 | $13 | $16 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $10 | $10 | $11 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $19 | $22 | $27 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $20 | $30 | $40 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $24 | $35 | $46 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $20 | $21 | $25 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $22 | $22 | $23 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $15 | $20 | $24 |
| Physical therapy evaluation low complexity CPT 97161 • Physical Therapy | $136 | $163 | $190 |