| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $584 | $902 | $1,448 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $165 | $1,014 | $2,054 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $1,611 | $1,756 | $1,872 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $463 | $1,584 | $2,162 |
| Carpal tunnel release CPT 64721 • Orthopedics | $183 | $634 | $878 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $30 | $220 | $334 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $88 | $229 | $494 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $10 | $152 | $288 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $195 | $386 | $505 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $737 | $2,828 | $4,147 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $3 | $75 | $146 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $33 | $75 | $98 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $219 | $314 | $481 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $6 | $103 | $199 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $160 | $227 | $345 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $89 | $146 | $178 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $215 | $267 | $299 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $73 | $577 | $864 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $58 | $192 | $326 |
| Cytopathology concentration technique CPT 88108 • Pathology | $14 | $25 | $37 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $22 | $22 | $23 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $10 | $12 | $15 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $3 | $6 | $9 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $16 | $19 | $23 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $13 | $16 | $18 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $5 | $13 | $20 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $4 | $5 | $5 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $7 | $15 | $24 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $41 | $53 | $60 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $51 | $112 | $174 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $120 | $181 | $243 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $16 | $44 | $72 |
| Special stain group II CPT 88313 • Pathology | $36 | $52 | $68 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $43 | $50 | $58 |
| Frozen section pathology each additional CPT 88332 • Pathology | $19 | $32 | $46 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $14 | $16 | $17 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $39 | $40 | $42 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $64 | $78 | $98 |
| Microdissection manual CPT 88381 • Pathology | $15 | $117 | $168 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $4 | $8 | $11 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $8 | $13 | $20 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $11 | $16 | $21 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $14 | $20 | $26 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $12 | $15 | $20 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $25 | $28 | $31 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $23 | $27 | $36 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $20 | $35 | $53 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $18 | $22 | $29 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $12 | $16 | $19 |
| Physical therapy evaluation low complexity CPT 97161 • Physical Therapy | $84 | $88 | $95 |