| Arthroscopy knee with meniscectomy CPT 29881 • Orthopedics | $529 | $643 | $929 |
| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $30 | $935 | $2,174 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $30 | $930 | $1,696 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $30 | $1,291 | $2,896 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $305 | $1,629 | $3,508 |
| Carpal tunnel release CPT 64721 • Orthopedics | $30 | $655 | $1,425 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $159 | $246 | $408 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $104 | $413 | $832 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $137 | $350 | $562 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $97 | $405 | $820 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $30 | $1,469 | $2,288 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $11 | $81 | $136 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $48 | $85 | $160 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $242 | $559 | $790 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $30 | $178 | $355 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $170 | $215 | $292 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $50 | $113 | $222 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $149 | $233 | $386 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $436 | $744 | $1,402 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $181 | $237 | $287 |
| Cytopathology concentration technique CPT 88108 • Pathology | $34 | $58 | $109 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $17 | $58 | $108 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $19 | $29 | $38 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $9 | $17 | $30 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $21 | $29 | $45 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $17 | $19 | $21 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $31 | $43 | $54 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $12 | $26 | $52 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $20 | $43 | $68 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $42 | $65 | $87 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $50 | $227 | $456 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $260 | $404 | $687 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $25 | $84 | $178 |
| Special stain group II CPT 88313 • Pathology | $7 | $42 | $130 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $38 | $61 | $110 |
| Frozen section pathology each additional CPT 88332 • Pathology | $8 | $50 | $87 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $38 | $91 | $144 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $21 | $91 | $168 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $32 | $50 | $95 |
| Microdissection manual CPT 88381 • Pathology | $45 | $184 | $316 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $5 | $5 | $6 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $10 | $12 | $15 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $9 | $18 | $36 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $12 | $25 | $44 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $11 | $14 | $22 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $24 | $31 | $36 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $28 | $30 | $32 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $24 | $25 | $28 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $22 | $27 | $30 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $14 | $16 | $17 |