| 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 | $1 | $19 | $32 |
| Immunization admin injection each additional CPT 90472 • Preventive Care | $2 | $6 | $11 |
| HPV vaccine 9-valent CPT 90651 • Preventive Care | $59 | $224 | $388 |
| Pneumococcal conjugate vaccine 13-valent CPT 90670 • Preventive Care | $272 | $283 | $304 |
| Rotavirus vaccine pentavalent CPT 90680 • Preventive Care | $120 | $122 | $123 |
| Influenza vaccine quadrivalent preservative free CPT 90686 • Preventive Care | $12 | $19 | $26 |
| MMR vaccine CPT 90707 • Preventive Care | $18 | $66 | $114 |
| Tdap vaccine age 7 years or older CPT 90715 • Preventive Care | $6 | $32 | $59 |
| Varicella vaccine CPT 90716 • Preventive Care | $23 | $125 | $226 |
| Pneumococcal vaccine adult CPT 90732 • Preventive Care | $138 | $140 | $141 |
| Zoster vaccine recombinant adjuvanted CPT 90750 • Preventive Care | $28 | $229 | $405 |
| Preventive visit new patient infant CPT 99381 • Preventive Care | $6 | $65 | $123 |
| Preventive visit new patient age 1-4 CPT 99382 • Preventive Care | $95 | $98 | $101 |
| Preventive visit new patient age 5-11 CPT 99383 • Preventive Care | $69 | $87 | $105 |
| Preventive visit new patient age 12-17 CPT 99384 • Preventive Care | $89 | $100 | $112 |
| Preventive visit new patient age 18-39 CPT 99385 • Preventive Care | $16 | $114 | $211 |
| Preventive visit new patient age 40-64 CPT 99386 • Preventive Care | $125 | $158 | $192 |
| Preventive visit new patient age 65+ CPT 99387 • Preventive Care | $68 | $167 | $265 |
| Preventive visit established patient infant CPT 99391 • Preventive Care | $55 | $66 | $86 |
| Preventive visit established patient age 1-4 CPT 99392 • Preventive Care | $61 | $72 | $87 |
| Preventive visit established patient age 5-11 CPT 99393 • Preventive Care | $44 | $93 | $123 |
| Preventive visit established patient age 12-17 CPT 99394 • Preventive Care | $95 | $140 | $186 |
| Preventive visit established patient age 18-39 CPT 99395 • Preventive Care | $97 | $127 | $182 |
| Preventive visit established patient age 40-64 CPT 99396 • Preventive Care | $78 | $94 | $110 |
| Preventive visit established patient age 65+ CPT 99397 • Preventive Care | $81 | $119 | $165 |
| Cervical or vaginal cancer screening pelvic exam HCPCS G0101 • Preventive Care | $26 | $36 | $46 |
| Colorectal cancer screening flexible sigmoidoscopy HCPCS G0104 • Preventive Care | $4 | $31 | $58 |
| Colorectal cancer screening colonoscopy high risk HCPCS G0105 • Preventive Care | $118 | $323 | $529 |
| Colorectal cancer screening colonoscopy not high risk HCPCS G0121 • Preventive Care | $233 | $382 | $530 |
| Initial preventive physical exam (Welcome to Medicare) HCPCS G0402 • Preventive Care | $86 | $102 | $112 |
| Annual wellness visit initial HCPCS G0438 • Preventive Care | $109 | $163 | $269 |
| Annual wellness visit subsequent HCPCS G0439 • Preventive Care | $86 | $118 | $183 |
| Bronchoscopy diagnostic CPT 31622 • Pulmonology | $21 | $204 | $387 |
| Bronchoscopy with brushing CPT 31623 • Pulmonology | $21 | $163 | $305 |
| Bronchoscopy with bronchial alveolar lavage CPT 31624 • Pulmonology | $133 | $234 | $294 |
| Bronchoscopy with biopsy CPT 31625 • Pulmonology | $44 | $148 | $253 |
| Bronchoscopy with transbronchial lung biopsy CPT 31628 • Pulmonology | $217 | $285 | $353 |
| Bronchoscopy with endobronchial ultrasound biopsy CPT 31652 • Pulmonology | $155 | $471 | $788 |
| Ventilation assist and management initiation CPT 94002 • Pulmonology | $82 | $87 | $89 |
| Spirometry CPT 94010 • Pulmonology | $19 | $26 | $32 |
| Spirometry before and after bronchodilator CPT 94060 • Pulmonology | $10 | $15 | $21 |
| Bronchospasm provocation evaluation CPT 94070 • Pulmonology | $13 | $34 | $55 |
| Respiratory flow volume loop CPT 94375 • Pulmonology | $14 | $30 | $39 |
| Cardiopulmonary exercise test CPT 94621 • Pulmonology | $79 | $110 | $141 |
| Nebulizer inhalation treatment CPT 94640 • Pulmonology | $6 | $16 | $28 |
| Aerosol or vapor inhalation initial demonstration CPT 94664 • Pulmonology | $4 | $19 | $28 |
| Plethysmography lung volumes CPT 94726 • Pulmonology | $28 | $44 | $56 |
| Gas dilution lung volumes CPT 94727 • Pulmonology | $11 | $12 | $12 |