| Laminectomy lumbar single level CPT 63047 • Orthopedics | $2,662 | $3,105 | $3,549 |
| Carpal tunnel release CPT 64721 • Orthopedics | $1,052 | $1,052 | $1,052 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $30 | $243 | $396 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $265 | $298 | $346 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $360 | $406 | $452 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $245 | $542 | $840 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $1,339 | $2,924 | $4,508 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $183 | $183 | $183 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $118 | $118 | $118 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $232 | $399 | $565 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $103 | $176 | $249 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $225 | $320 | $415 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $59 | $104 | $128 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $359 | $359 | $359 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $461 | $727 | $994 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $148 | $169 | $190 |
| Cytopathology concentration technique CPT 88108 • Pathology | $22 | $52 | $81 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $13 | $45 | $84 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $15 | $22 | $28 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $9 | $15 | $21 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $16 | $26 | $35 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $13 | $19 | $28 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $20 | $31 | $43 |
| 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 | $5 | $27 | $52 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $17 | $33 | $42 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $37 | $170 | $361 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $153 | $352 | $550 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $44 | $93 | $142 |
| Special stain group II CPT 88313 • Pathology | $5 | $44 | $102 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $20 | $75 | $131 |
| Frozen section pathology each additional CPT 88332 • Pathology | $32 | $51 | $69 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $13 | $59 | $112 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $16 | $55 | $128 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $26 | $40 | $54 |
| Microdissection manual CPT 88381 • Pathology | $87 | $175 | $263 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $4 | $8 | $14 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $12 | $19 | $30 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $9 | $16 | $28 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $10 | $20 | $35 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $11 | $20 | $34 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $20 | $24 | $30 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $23 | $27 | $35 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $20 | $40 | $71 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $18 | $22 | $28 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $12 | $15 | $18 |
| Physical therapy evaluation low complexity CPT 97161 • Physical Therapy | $66 | $75 | $84 |
| Physical therapy evaluation moderate complexity CPT 97162 • Physical Therapy | $66 | $73 | $84 |
| Physical therapy evaluation high complexity CPT 97163 • Physical Therapy | $75 | $133 | $241 |
| Physical therapy re-evaluation CPT 97164 • Physical Therapy | $38 | $78 | $165 |