| Discectomy lumbar single level CPT 63030 • Orthopedics | $30 | $1,292 | $3,121 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $30 | $1,695 | $3,551 |
| Carpal tunnel release CPT 64721 • Orthopedics | $30 | $503 | $1,367 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $32 | $243 | $523 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $258 | $446 | $797 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $502 | $502 | $502 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $38 | $393 | $782 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $30 | $551 | $1,375 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $74 | $165 | $257 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $33 | $76 | $157 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $30 | $232 | $375 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $30 | $106 | $175 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $170 | $322 | $561 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $88 | $142 | $282 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $150 | $253 | $405 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $318 | $710 | $1,376 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $68 | $292 | $569 |
| Cytopathology concentration technique CPT 88108 • Pathology | $49 | $62 | $74 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $28 | $39 | $51 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $30 | $30 | $30 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $13 | $14 | $14 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $21 | $38 | $58 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $17 | $18 | $20 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $25 | $28 | $30 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $28 | $28 | $28 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $31 | $36 | $41 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $30 | $42 | $54 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $82 | $150 | $219 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $145 | $145 | $145 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $86 | $88 | $89 |
| Special stain group II CPT 88313 • Pathology | $12 | $41 | $61 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $40 | $50 | $61 |
| Frozen section pathology each additional CPT 88332 • Pathology | $12 | $26 | $41 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $21 | $53 | $71 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $15 | $41 | $77 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $32 | $49 | $60 |
| Microdissection manual CPT 88381 • Pathology | $54 | $145 | $236 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $5 | $9 | $13 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $10 | $24 | $35 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $9 | $27 | $42 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $12 | $27 | $43 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $17 | $25 | $29 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $37 | $56 | $71 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $28 | $50 | $74 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $24 | $45 | $63 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $22 | $41 | $67 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $38 | $38 | $39 |
| Physical therapy evaluation low complexity CPT 97161 • Physical Therapy | $83 | $126 | $180 |
| Physical therapy evaluation moderate complexity CPT 97162 • Physical Therapy | $83 | $115 | $180 |
| Physical therapy evaluation high complexity CPT 97163 • Physical Therapy | $117 | $149 | $180 |