| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $42 | $707 | $1,372 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $1,294 | $1,336 | $1,379 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $1,482 | $1,562 | $1,642 |
| Carpal tunnel release CPT 64721 • Orthopedics | $571 | $594 | $617 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $272 | $310 | $348 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $402 | $402 | $402 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $253 | $253 | $253 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $394 | $394 | $395 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $598 | $617 | $636 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $114 | $129 | $144 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $78 | $78 | $78 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $436 | $512 | $589 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $42 | $127 | $212 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $255 | $315 | $375 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $68 | $100 | $131 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $224 | $230 | $236 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $393 | $549 | $704 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $105 | $200 | $294 |
| Cytopathology concentration technique CPT 88108 • Pathology | $37 | $38 | $39 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $41 | $56 | $70 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $20 | $28 | $36 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $9 | $16 | $22 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $19 | $37 | $54 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $15 | $23 | $30 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $31 | $35 | $39 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $18 | $44 | $69 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $24 | $55 | $85 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $53 | $111 | $170 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $163 | $223 | $284 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $233 | $240 | $248 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $38 | $84 | $130 |
| Special stain group II CPT 88313 • Pathology | $81 | $87 | $90 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $20 | $52 | $85 |
| Frozen section pathology each additional CPT 88332 • Pathology | $33 | $37 | $42 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $56 | $62 | $67 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $76 | $118 | $160 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $27 | $56 | $86 |
| Microdissection manual CPT 88381 • Pathology | $92 | $156 | $220 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $5 | $5 | $5 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $14 | $14 | $14 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $15 | $15 | $15 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $16 | $16 | $16 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $12 | $12 | $12 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $41 | $41 | $41 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $43 | $43 | $43 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $36 | $36 | $36 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $39 | $39 | $39 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $26 | $26 | $26 |
| Physical therapy evaluation low complexity CPT 97161 • Physical Therapy | $132 | $132 | $132 |
| Physical therapy evaluation moderate complexity CPT 97162 • Physical Therapy | $132 | $132 | $132 |