| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $433 | $1,033 | $1,650 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $44 | $1,033 | $1,695 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $192 | $984 | $1,664 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $1,038 | $1,309 | $1,529 |
| Carpal tunnel release CPT 64721 • Orthopedics | $442 | $565 | $732 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $44 | $198 | $364 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $121 | $254 | $420 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $188 | $213 | $238 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $125 | $286 | $413 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $519 | $2,026 | $2,987 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $54 | $64 | $79 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $49 | $65 | $82 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $210 | $259 | $314 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $121 | $172 | $262 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $178 | $243 | $319 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $91 | $131 | $162 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $144 | $181 | $245 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $451 | $625 | $963 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $64 | $266 | $395 |
| Cytopathology concentration technique CPT 88108 • Pathology | $29 | $58 | $106 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $29 | $43 | $63 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $12 | $24 | $39 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $6 | $11 | $16 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $16 | $20 | $25 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $21 | $21 | $21 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $30 | $36 | $41 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $5 | $15 | $31 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $15 | $34 | $48 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $49 | $66 | $81 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $107 | $331 | $614 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $190 | $270 | $419 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $34 | $74 | $107 |
| Special stain group II CPT 88313 • Pathology | $16 | $76 | $117 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $29 | $78 | $166 |
| Frozen section pathology each additional CPT 88332 • Pathology | $32 | $35 | $40 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $31 | $76 | $153 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $46 | $103 | $180 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $58 | $134 | $237 |
| Microdissection manual CPT 88381 • Pathology | $193 | $208 | $222 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $7 | $10 | $14 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $14 | $21 | $27 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $14 | $21 | $33 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $15 | $24 | $33 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $13 | $17 | $22 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $26 | $31 | $38 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $30 | $36 | $44 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $26 | $32 | $34 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $27 | $43 | $71 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $16 | $18 | $20 |
| Physical therapy evaluation low complexity CPT 97161 • Physical Therapy | $91 | $100 | $106 |