| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $1,053 | $1,072 | $1,091 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $220 | $754 | $1,287 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $1,229 | $1,368 | $1,506 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $204 | $937 | $1,670 |
| Carpal tunnel release CPT 64721 • Orthopedics | $537 | $625 | $713 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $96 | $217 | $329 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $121 | $323 | $468 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $220 | $220 | $220 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $112 | $191 | $318 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $596 | $1,243 | $1,891 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $154 | $154 | $154 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $62 | $69 | $79 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $194 | $282 | $348 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $91 | $148 | $206 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $146 | $238 | $351 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $99 | $112 | $121 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $221 | $233 | $245 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $318 | $541 | $757 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $68 | $156 | $296 |
| Cytopathology concentration technique CPT 88108 • Pathology | $17 | $18 | $20 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $26 | $30 | $34 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $17 | $18 | $20 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $9 | $13 | $16 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $23 | $35 | $58 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $10 | $16 | $20 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $17 | $17 | $17 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $24 | $27 | $29 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $7 | $22 | $37 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $22 | $26 | $30 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $48 | $188 | $258 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $105 | $248 | $390 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $44 | $72 | $99 |
| Special stain group II CPT 88313 • Pathology | $35 | $50 | $72 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $17 | $28 | $39 |
| Frozen section pathology each additional CPT 88332 • Pathology | $24 | $37 | $49 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $28 | $53 | $77 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $35 | $62 | $89 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $32 | $34 | $37 |
| Microdissection manual CPT 88381 • Pathology | $34 | $106 | $178 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $5 | $6 | $9 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $14 | $19 | $24 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $8 | $12 | $16 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $10 | $15 | $18 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $10 | $13 | $18 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $22 | $29 | $37 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $25 | $34 | $47 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $25 | $35 | $42 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $20 | $27 | $34 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $13 | $16 | $19 |
| Physical therapy evaluation low complexity CPT 97161 • Physical Therapy | $76 | $92 | $117 |