| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $683 | $869 | $1,054 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $970 | $1,159 | $1,348 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $180 | $662 | $944 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $204 | $775 | $1,081 |
| Carpal tunnel release CPT 64721 • Orthopedics | $427 | $485 | $586 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $127 | $190 | $276 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $121 | $241 | $324 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $139 | $143 | $146 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $242 | $288 | $357 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $596 | $1,214 | $1,832 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $43 | $67 | $93 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $35 | $50 | $66 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $194 | $221 | $251 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $95 | $108 | $114 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $169 | $178 | $187 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $85 | $95 | $108 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $144 | $164 | $203 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $220 | $343 | $452 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $75 | $181 | $249 |
| Cytopathology concentration technique CPT 88108 • Pathology | $16 | $39 | $63 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $13 | $40 | $63 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $21 | $23 | $25 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $10 | $13 | $16 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $25 | $36 | $58 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $21 | $21 | $21 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $23 | $23 | $23 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $16 | $23 | $30 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $5 | $21 | $40 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $17 | $52 | $70 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $37 | $102 | $125 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $105 | $262 | $419 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $74 | $90 | $107 |
| Special stain group II CPT 88313 • Pathology | $5 | $41 | $78 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $22 | $41 | $60 |
| Frozen section pathology each additional CPT 88332 • Pathology | $52 | $53 | $53 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $13 | $54 | $71 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $16 | $35 | $61 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $77 | $95 | $113 |
| Microdissection manual CPT 88381 • Pathology | $85 | $160 | $236 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $5 | $7 | $10 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $12 | $18 | $32 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $9 | $21 | $32 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $10 | $19 | $36 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $14 | $21 | $27 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $30 | $44 | $61 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $27 | $36 | $47 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $30 | $42 | $55 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $28 | $33 | $40 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $18 | $28 | $38 |
| Physical therapy evaluation low complexity CPT 97161 • Physical Therapy | $84 | $97 | $115 |