| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $56 | $548 | $1,039 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $40 | $770 | $1,500 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $121 | $768 | $1,415 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $918 | $1,270 | $1,621 |
| Carpal tunnel release CPT 64721 • Orthopedics | $67 | $346 | $625 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $29 | $163 | $297 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $10 | $182 | $440 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $39 | $131 | $277 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $13 | $98 | $183 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $233 | $444 | $655 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $6 | $68 | $158 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $30 | $49 | $69 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $41 | $259 | $476 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $16 | $58 | $103 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $58 | $234 | $410 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $45 | $60 | $74 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $130 | $194 | $258 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $99 | $458 | $817 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $31 | $186 | $341 |
| Cytopathology concentration technique CPT 88108 • Pathology | $9 | $27 | $46 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $62 | $98 | $149 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $9 | $25 | $41 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $10 | $18 | $26 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $12 | $38 | $64 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $7 | $18 | $35 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $18 | $32 | $45 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $4 | $42 | $80 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $8 | $53 | $99 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $13 | $90 | $168 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $129 | $230 | $332 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $87 | $155 | $223 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $44 | $44 | $44 |
| Special stain group II CPT 88313 • Pathology | $7 | $60 | $113 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $28 | $37 | $46 |
| Frozen section pathology each additional CPT 88332 • Pathology | $6 | $11 | $16 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $9 | $63 | $118 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $12 | $51 | $89 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $34 | $88 | $190 |
| Microdissection manual CPT 88381 • Pathology | $84 | $183 | $348 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $3 | $4 | $5 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $8 | $11 | $16 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $9 | $12 | $17 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $9 | $12 | $19 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $7 | $9 | $13 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $16 | $26 | $45 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $17 | $27 | $47 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $14 | $23 | $40 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $15 | $24 | $42 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $10 | $16 | $29 |
| Physical therapy evaluation low complexity CPT 97161 • Physical Therapy | $49 | $97 | $144 |