| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $314 | $390 | $466 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $45 | $351 | $656 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $621 | $810 | $905 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $721 | $833 | $1,029 |
| Carpal tunnel release CPT 64721 • Orthopedics | $188 | $290 | $378 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $7 | $54 | $110 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $71 | $72 | $73 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $91 | $95 | $100 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $44 | $105 | $206 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $826 | $1,175 | $1,523 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $6 | $17 | $28 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $22 | $34 | $41 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $72 | $140 | $182 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $7 | $41 | $74 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $59 | $88 | $144 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $61 | $69 | $73 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $67 | $95 | $134 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $143 | $262 | $348 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $143 | $152 | $161 |
| Cytopathology concentration technique CPT 88108 • Pathology | $25 | $35 | $41 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $25 | $30 | $42 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $4 | $13 | $20 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $2 | $7 | $11 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $10 | $15 | $20 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $2 | $8 | $13 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $10 | $15 | $20 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $5 | $15 | $20 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $5 | $12 | $25 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $18 | $31 | $43 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $33 | $82 | $165 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $51 | $160 | $253 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $17 | $49 | $68 |
| Special stain group II CPT 88313 • Pathology | $22 | $38 | $50 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $12 | $31 | $61 |
| Frozen section pathology each additional CPT 88332 • Pathology | $15 | $21 | $32 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $16 | $33 | $56 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $13 | $48 | $66 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $35 | $53 | $72 |
| Microdissection manual CPT 88381 • Pathology | $75 | $90 | $121 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $3 | $4 | $4 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $8 | $9 | $9 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $8 | $10 | $11 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $10 | $10 | $11 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $7 | $8 | $9 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $18 | $20 | $23 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $23 | $25 | $27 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $15 | $17 | $20 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $16 | $17 | $18 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $9 | $10 | $12 |
| Physical therapy evaluation low complexity CPT 97161 • Physical Therapy | $23 | $46 | $67 |