| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $1,679 | $1,853 | $2,028 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $956 | $1,671 | $2,387 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $1,513 | $2,161 | $2,808 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $1,721 | $2,191 | $2,662 |
| Carpal tunnel release CPT 64721 • Orthopedics | $666 | $852 | $1,038 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $158 | $174 | $205 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $174 | $387 | $728 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $241 | $300 | $360 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $375 | $547 | $719 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $652 | $2,638 | $4,624 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $72 | $147 | $222 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $75 | $96 | $118 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $336 | $494 | $653 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $129 | $129 | $129 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $221 | $242 | $264 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $133 | $194 | $254 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $211 | $264 | $359 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $437 | $690 | $994 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $240 | $296 | $408 |
| Cytopathology concentration technique CPT 88108 • Pathology | $36 | $59 | $81 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $22 | $53 | $84 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $19 | $24 | $28 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $9 | $15 | $21 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $18 | $27 | $35 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $13 | $21 | $28 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $20 | $22 | $25 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $18 | $29 | $40 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $7 | $30 | $52 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $17 | $23 | $29 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $51 | $210 | $361 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $239 | $394 | $550 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $16 | $79 | $142 |
| Special stain group II CPT 88313 • Pathology | $35 | $68 | $102 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $30 | $44 | $58 |
| Frozen section pathology each additional CPT 88332 • Pathology | $19 | $44 | $69 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $36 | $74 | $112 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $40 | $84 | $128 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $48 | $51 | $54 |
| Microdissection manual CPT 88381 • Pathology | $16 | $140 | $263 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $5 | $9 | $14 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $10 | $12 | $15 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $9 | $11 | $12 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $15 | $25 | $35 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $14 | $24 | $34 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $31 | $51 | $71 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $35 | $56 | $82 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $24 | $27 | $30 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $28 | $45 | $65 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $18 | $30 | $42 |
| Physical therapy evaluation low complexity CPT 97161 • Physical Therapy | $84 | $165 | $241 |