| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $601 | $940 | $1,619 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $854 | $1,400 | $2,493 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $817 | $1,265 | $2,162 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $929 | $1,761 | $2,592 |
| Carpal tunnel release CPT 64721 • Orthopedics | $368 | $559 | $940 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $169 | $280 | $494 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $231 | $450 | $815 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $243 | $268 | $293 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $227 | $370 | $657 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $366 | $924 | $1,389 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $92 | $176 | $264 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $43 | $63 | $104 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $220 | $563 | $907 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $97 | $225 | $403 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $159 | $368 | $577 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $79 | $144 | $274 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $123 | $212 | $391 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $408 | $489 | $653 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $173 | $303 | $562 |
| Cytopathology concentration technique CPT 88108 • Pathology | $66 | $89 | $135 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $89 | $199 | $310 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $25 | $42 | $60 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $40 | $45 | $50 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $31 | $53 | $98 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $55 | $70 | $85 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $80 | $95 | $111 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $19 | $25 | $30 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $55 | $80 | $106 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $90 | $99 | $109 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $125 | $146 | $188 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $300 | $315 | $330 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $94 | $139 | $183 |
| Special stain group II CPT 88313 • Pathology | $35 | $58 | $69 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $46 | $74 | $98 |
| Frozen section pathology each additional CPT 88332 • Pathology | $35 | $72 | $109 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $60 | $60 | $60 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $33 | $82 | $123 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $63 | $150 | $278 |
| Microdissection manual CPT 88381 • Pathology | $391 | $395 | $399 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $4 | $10 | $21 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $14 | $26 | $51 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $14 | $26 | $49 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $14 | $26 | $49 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $12 | $14 | $14 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $23 | $48 | $74 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $75 | $96 | $116 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $14 | $33 | $64 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $13 | $41 | $69 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $45 | $53 | $61 |
| Physical therapy evaluation low complexity CPT 97161 • Physical Therapy | $63 | $141 | $219 |