| Immunization admin first vaccine component CPT 90460 • Preventive Care | $24 | $25 | $27 |
| Immunization admin each additional component CPT 90461 • Preventive Care | $12 | $13 | $13 |
| Immunization admin injection single CPT 90471 • Preventive Care | $10 | $15 | $23 |
| Immunization admin injection each additional CPT 90472 • Preventive Care | $10 | $11 | $12 |
| HPV vaccine 9-valent CPT 90651 • Preventive Care | $369 | $381 | $394 |
| Pneumococcal conjugate vaccine 13-valent CPT 90670 • Preventive Care | $230 | $256 | $310 |
| Rotavirus vaccine pentavalent CPT 90680 • Preventive Care | $115 | $119 | $122 |
| Influenza vaccine quadrivalent preservative free CPT 90686 • Preventive Care | $22 | $24 | $27 |
| MMR vaccine CPT 90707 • Preventive Care | $15 | $79 | $116 |
| Tdap vaccine age 7 years or older CPT 90715 • Preventive Care | $55 | $57 | $60 |
| Varicella vaccine CPT 90716 • Preventive Care | $215 | $223 | $230 |
| Pneumococcal vaccine adult CPT 90732 • Preventive Care | $131 | $135 | $141 |
| Zoster vaccine recombinant adjuvanted CPT 90750 • Preventive Care | $219 | $240 | $259 |
| Preventive visit new patient infant CPT 99381 • Preventive Care | $5 | $67 | $105 |
| Preventive visit new patient age 1-4 CPT 99382 • Preventive Care | $78 | $94 | $109 |
| Preventive visit new patient age 5-11 CPT 99383 • Preventive Care | $113 | $114 | $115 |
| Preventive visit new patient age 12-17 CPT 99384 • Preventive Care | $5 | $80 | $128 |
| Preventive visit new patient age 18-39 CPT 99385 • Preventive Care | $5 | $65 | $124 |
| Preventive visit new patient age 40-64 CPT 99386 • Preventive Care | $108 | $125 | $144 |
| Preventive visit new patient age 65+ CPT 99387 • Preventive Care | $156 | $158 | $160 |
| Preventive visit established patient infant CPT 99391 • Preventive Care | $5 | $49 | $93 |
| Preventive visit established patient age 1-4 CPT 99392 • Preventive Care | $9 | $67 | $100 |
| Preventive visit established patient age 5-11 CPT 99393 • Preventive Care | $72 | $83 | $92 |
| Preventive visit established patient age 12-17 CPT 99394 • Preventive Care | $78 | $80 | $81 |
| Preventive visit established patient age 18-39 CPT 99395 • Preventive Care | $103 | $107 | $111 |
| Preventive visit established patient age 40-64 CPT 99396 • Preventive Care | $91 | $102 | $114 |
| Preventive visit established patient age 65+ CPT 99397 • Preventive Care | $41 | $98 | $128 |
| Cervical or vaginal cancer screening pelvic exam HCPCS G0101 • Preventive Care | $36 | $36 | $36 |
| Colorectal cancer screening flexible sigmoidoscopy HCPCS G0104 • Preventive Care | $62 | $95 | $127 |
| Colorectal cancer screening colonoscopy high risk HCPCS G0105 • Preventive Care | $36 | $184 | $390 |
| Colorectal cancer screening colonoscopy not high risk HCPCS G0121 • Preventive Care | $127 | $292 | $390 |
| Initial preventive physical exam (Welcome to Medicare) HCPCS G0402 • Preventive Care | $130 | $135 | $151 |
| Annual wellness visit initial HCPCS G0438 • Preventive Care | $143 | $149 | $161 |
| Annual wellness visit subsequent HCPCS G0439 • Preventive Care | $97 | $101 | $108 |
| Bronchoscopy diagnostic CPT 31622 • Pulmonology | $41 | $120 | $177 |
| Bronchoscopy with brushing CPT 31623 • Pulmonology | $143 | $274 | $406 |
| Bronchoscopy with bronchial alveolar lavage CPT 31624 • Pulmonology | $131 | $273 | $378 |
| Bronchoscopy with biopsy CPT 31625 • Pulmonology | $166 | $285 | $403 |
| Bronchoscopy with transbronchial lung biopsy CPT 31628 • Pulmonology | $380 | $427 | $474 |
| Bronchoscopy with endobronchial ultrasound biopsy CPT 31652 • Pulmonology | $223 | $657 | $1,092 |
| Ventilation assist and management initiation CPT 94002 • Pulmonology | $83 | $86 | $90 |
| Spirometry CPT 94010 • Pulmonology | $24 | $31 | $41 |
| Spirometry before and after bronchodilator CPT 94060 • Pulmonology | $12 | $34 | $56 |
| Bronchospasm provocation evaluation CPT 94070 • Pulmonology | $28 | $44 | $60 |
| Respiratory flow volume loop CPT 94375 • Pulmonology | $14 | $25 | $41 |
| Cardiopulmonary exercise test CPT 94621 • Pulmonology | $66 | $107 | $148 |
| Nebulizer inhalation treatment CPT 94640 • Pulmonology | $12 | $15 | $17 |
| Aerosol or vapor inhalation initial demonstration CPT 94664 • Pulmonology | $13 | $15 | $17 |
| Plethysmography lung volumes CPT 94726 • Pulmonology | $15 | $36 | $53 |
| Gas dilution lung volumes CPT 94727 • Pulmonology | $15 | $29 | $41 |