| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $1,594 | $1,718 | $1,967 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $1,472 | $1,619 | $1,913 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $1,698 | $1,937 | $2,177 |
| Carpal tunnel release CPT 64721 • Orthopedics | $659 | $721 | $843 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $172 | $281 | $335 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $258 | $335 | $489 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $178 | $178 | $178 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $204 | $238 | $255 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $843 | $843 | $843 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $157 | $161 | $163 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $49 | $65 | $96 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $437 | $497 | $556 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $175 | $236 | $267 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $171 | $257 | $344 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $89 | $117 | $173 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $150 | $183 | $249 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $437 | $444 | $458 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $124 | $201 | $240 |
| Cytopathology concentration technique CPT 88108 • Pathology | $59 | $67 | $74 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $28 | $28 | $28 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $30 | $35 | $40 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $14 | $14 | $14 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $35 | $56 | $66 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $20 | $20 | $20 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $30 | $30 | $30 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $28 | $40 | $52 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $11 | $31 | $51 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $55 | $61 | $67 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $82 | $166 | $231 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $269 | $310 | $352 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $27 | $58 | $90 |
| Special stain group II CPT 88313 • Pathology | $12 | $38 | $65 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $61 | $81 | $102 |
| Frozen section pathology each additional CPT 88332 • Pathology | $42 | $47 | $52 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $21 | $48 | $75 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $54 | $75 | $97 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $66 | $68 | $70 |
| Microdissection manual CPT 88381 • Pathology | $98 | $98 | $98 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $9 | $9 | $9 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $25 | $25 | $25 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $30 | $30 | $30 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $30 | $30 | $30 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $20 | $20 | $20 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $46 | $48 | $51 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $48 | $50 | $53 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $44 | $44 | $44 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $44 | $45 | $47 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $28 | $28 | $28 |
| Physical therapy evaluation low complexity CPT 97161 • Physical Therapy | $84 | $104 | $125 |
| Physical therapy evaluation moderate complexity CPT 97162 • Physical Therapy | $84 | $104 | $125 |