| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $220 | $919 | $1,532 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $781 | $1,230 | $1,506 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $886 | $1,298 | $1,710 |
| Carpal tunnel release CPT 64721 • Orthopedics | $344 | $564 | $734 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $36 | $130 | $245 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $171 | $266 | $380 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $119 | $179 | $239 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $116 | $227 | $373 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $332 | $1,493 | $2,723 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $34 | $82 | $123 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $38 | $55 | $75 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $187 | $290 | $348 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $82 | $126 | $155 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $137 | $217 | $262 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $41 | $90 | $133 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $120 | $185 | $221 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $177 | $444 | $635 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $48 | $198 | $286 |
| Cytopathology concentration technique CPT 88108 • Pathology | $24 | $24 | $24 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $17 | $24 | $31 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $11 | $15 | $17 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $9 | $9 | $9 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $12 | $20 | $25 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $13 | $13 | $13 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $21 | $21 | $21 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $4 | $4 | $4 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $18 | $19 | $19 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $17 | $34 | $65 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $52 | $52 | $52 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $165 | $165 | $165 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $39 | $43 | $48 |
| Special stain group II CPT 88313 • Pathology | $32 | $36 | $39 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $60 | $60 | $60 |
| Frozen section pathology each additional CPT 88332 • Pathology | $33 | $33 | $33 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $31 | $44 | $57 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $35 | $50 | $64 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $76 | $76 | $76 |
| Microdissection manual CPT 88381 • Pathology | $94 | $94 | $94 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $5 | $5 | $5 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $11 | $12 | $12 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $8 | $9 | $10 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $12 | $12 | $12 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $10 | $13 | $17 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $22 | $24 | $25 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $25 | $31 | $40 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $20 | $27 | $35 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $19 | $23 | $27 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $14 | $14 | $14 |
| Physical therapy evaluation low complexity CPT 97161 • Physical Therapy | $68 | $87 | $117 |
| Physical therapy evaluation moderate complexity CPT 97162 • Physical Therapy | $68 | $86 | $101 |