| Immunization admin first vaccine component CPT 90460 • Preventive Care | $10 | $14 | $22 |
| Immunization admin each additional component CPT 90461 • Preventive Care | $5 | $7 | $11 |
| Immunization admin injection single CPT 90471 • Preventive Care | $2 | $12 | $22 |
| Immunization admin injection each additional CPT 90472 • Preventive Care | $2 | $8 | $11 |
| HPV vaccine 9-valent CPT 90651 • Preventive Care | $67 | $244 | $336 |
| Pneumococcal conjugate vaccine 13-valent CPT 90670 • Preventive Care | $230 | $240 | $258 |
| Rotavirus vaccine pentavalent CPT 90680 • Preventive Care | $16 | $74 | $104 |
| Influenza vaccine quadrivalent preservative free CPT 90686 • Preventive Care | $10 | $17 | $22 |
| MMR vaccine CPT 90707 • Preventive Care | $15 | $71 | $100 |
| Tdap vaccine age 7 years or older CPT 90715 • Preventive Care | $4 | $31 | $50 |
| Varicella vaccine CPT 90716 • Preventive Care | $29 | $139 | $195 |
| Pneumococcal vaccine adult CPT 90732 • Preventive Care | $67 | $106 | $133 |
| Zoster vaccine recombinant adjuvanted CPT 90750 • Preventive Care | $48 | $161 | $220 |
| Preventive visit new patient infant CPT 99381 • Preventive Care | $13 | $72 | $127 |
| Preventive visit new patient age 1-4 CPT 99382 • Preventive Care | $69 | $98 | $138 |
| Preventive visit new patient age 5-11 CPT 99383 • Preventive Care | $21 | $95 | $137 |
| Preventive visit new patient age 12-17 CPT 99384 • Preventive Care | $10 | $84 | $138 |
| Preventive visit new patient age 18-39 CPT 99385 • Preventive Care | $52 | $113 | $149 |
| Preventive visit new patient age 40-64 CPT 99386 • Preventive Care | $160 | $167 | $173 |
| Preventive visit new patient age 65+ CPT 99387 • Preventive Care | $29 | $132 | $191 |
| Preventive visit established patient infant CPT 99391 • Preventive Care | $10 | $59 | $99 |
| Preventive visit established patient age 1-4 CPT 99392 • Preventive Care | $8 | $59 | $110 |
| Preventive visit established patient age 5-11 CPT 99393 • Preventive Care | $12 | $80 | $118 |
| Preventive visit established patient age 12-17 CPT 99394 • Preventive Care | $13 | $67 | $120 |
| Preventive visit established patient age 18-39 CPT 99395 • Preventive Care | $9 | $65 | $120 |
| Preventive visit established patient age 40-64 CPT 99396 • Preventive Care | $98 | $115 | $142 |
| Preventive visit established patient age 65+ CPT 99397 • Preventive Care | $116 | $141 | $160 |
| Cervical or vaginal cancer screening pelvic exam HCPCS G0101 • Preventive Care | $4 | $24 | $35 |
| Colorectal cancer screening flexible sigmoidoscopy HCPCS G0104 • Preventive Care | $59 | $140 | $227 |
| Colorectal cancer screening colonoscopy high risk HCPCS G0105 • Preventive Care | $38 | $201 | $363 |
| Colorectal cancer screening colonoscopy not high risk HCPCS G0121 • Preventive Care | $134 | $389 | $652 |
| Initial preventive physical exam (Welcome to Medicare) HCPCS G0402 • Preventive Care | $120 | $149 | $186 |
| Annual wellness visit initial HCPCS G0438 • Preventive Care | $154 | $170 | $202 |
| Annual wellness visit subsequent HCPCS G0439 • Preventive Care | $104 | $114 | $135 |
| Bronchoscopy diagnostic CPT 31622 • Pulmonology | $20 | $275 | $519 |
| Bronchoscopy with brushing CPT 31623 • Pulmonology | $26 | $298 | $558 |
| Bronchoscopy with bronchial alveolar lavage CPT 31624 • Pulmonology | $20 | $191 | $522 |
| Bronchoscopy with biopsy CPT 31625 • Pulmonology | $115 | $328 | $561 |
| Bronchoscopy with transbronchial lung biopsy CPT 31628 • Pulmonology | $55 | $186 | $318 |
| Bronchoscopy with endobronchial ultrasound biopsy CPT 31652 • Pulmonology | $219 | $843 | $1,446 |
| Ventilation assist and management initiation CPT 94002 • Pulmonology | $90 | $98 | $114 |
| Spirometry CPT 94010 • Pulmonology | $33 | $37 | $44 |
| Spirometry before and after bronchodilator CPT 94060 • Pulmonology | $32 | $51 | $63 |
| Bronchospasm provocation evaluation CPT 94070 • Pulmonology | $12 | $36 | $61 |
| Respiratory flow volume loop CPT 94375 • Pulmonology | $19 | $28 | $39 |
| Cardiopulmonary exercise test CPT 94621 • Pulmonology | $33 | $106 | $168 |
| Nebulizer inhalation treatment CPT 94640 • Pulmonology | $20 | $26 | $33 |
| Aerosol or vapor inhalation initial demonstration CPT 94664 • Pulmonology | $3 | $12 | $20 |
| Plethysmography lung volumes CPT 94726 • Pulmonology | $44 | $55 | $67 |
| Gas dilution lung volumes CPT 94727 • Pulmonology | $9 | $35 | $52 |