| Immunization admin first vaccine component CPT 90460 • Preventive Care | $10 | $17 | $31 |
| Immunization admin each additional component CPT 90461 • Preventive Care | $5 | $9 | $16 |
| Immunization admin injection single CPT 90471 • Preventive Care | $2 | $16 | $31 |
| Immunization admin injection each additional CPT 90472 • Preventive Care | $5 | $10 | $16 |
| HPV vaccine 9-valent CPT 90651 • Preventive Care | $79 | $287 | $394 |
| Pneumococcal conjugate vaccine 13-valent CPT 90670 • Preventive Care | $271 | $282 | $304 |
| Rotavirus vaccine pentavalent CPT 90680 • Preventive Care | $18 | $70 | $121 |
| Influenza vaccine quadrivalent preservative free CPT 90686 • Preventive Care | $12 | $19 | $26 |
| MMR vaccine CPT 90707 • Preventive Care | $23 | $69 | $114 |
| Tdap vaccine age 7 years or older CPT 90715 • Preventive Care | $6 | $32 | $59 |
| Varicella vaccine CPT 90716 • Preventive Care | $115 | $171 | $227 |
| Pneumococcal vaccine adult CPT 90732 • Preventive Care | $28 | $102 | $140 |
| Zoster vaccine recombinant adjuvanted CPT 90750 • Preventive Care | $56 | $190 | $258 |
| Preventive visit new patient infant CPT 99381 • Preventive Care | $91 | $113 | $134 |
| Preventive visit new patient age 1-4 CPT 99382 • Preventive Care | $48 | $94 | $140 |
| Preventive visit new patient age 5-11 CPT 99383 • Preventive Care | $49 | $98 | $146 |
| Preventive visit new patient age 12-17 CPT 99384 • Preventive Care | $8 | $84 | $164 |
| Preventive visit new patient age 18-39 CPT 99385 • Preventive Care | $108 | $114 | $119 |
| Preventive visit new patient age 40-64 CPT 99386 • Preventive Care | $13 | $107 | $185 |
| Preventive visit new patient age 65+ CPT 99387 • Preventive Care | $10 | $83 | $155 |
| Preventive visit established patient infant CPT 99391 • Preventive Care | $55 | $74 | $85 |
| Preventive visit established patient age 1-4 CPT 99392 • Preventive Care | $9 | $54 | $93 |
| Preventive visit established patient age 5-11 CPT 99393 • Preventive Care | $9 | $66 | $128 |
| Preventive visit established patient age 12-17 CPT 99394 • Preventive Care | $95 | $100 | $106 |
| Preventive visit established patient age 18-39 CPT 99395 • Preventive Care | $49 | $88 | $143 |
| Preventive visit established patient age 40-64 CPT 99396 • Preventive Care | $16 | $84 | $153 |
| Preventive visit established patient age 65+ CPT 99397 • Preventive Care | $17 | $91 | $165 |
| Cervical or vaginal cancer screening pelvic exam HCPCS G0101 • Preventive Care | $3 | $19 | $34 |
| Colorectal cancer screening flexible sigmoidoscopy HCPCS G0104 • Preventive Care | $4 | $39 | $77 |
| Colorectal cancer screening colonoscopy high risk HCPCS G0105 • Preventive Care | $12 | $215 | $419 |
| Colorectal cancer screening colonoscopy not high risk HCPCS G0121 • Preventive Care | $117 | $185 | $254 |
| Initial preventive physical exam (Welcome to Medicare) HCPCS G0402 • Preventive Care | $109 | $140 | $202 |
| Annual wellness visit initial HCPCS G0438 • Preventive Care | $109 | $142 | $208 |
| Annual wellness visit subsequent HCPCS G0439 • Preventive Care | $86 | $104 | $141 |
| Bronchoscopy diagnostic CPT 31622 • Pulmonology | $42 | $110 | $178 |
| Bronchoscopy with brushing CPT 31623 • Pulmonology | $72 | $215 | $359 |
| Bronchoscopy with bronchial alveolar lavage CPT 31624 • Pulmonology | $44 | $141 | $336 |
| Bronchoscopy with biopsy CPT 31625 • Pulmonology | $41 | $240 | $440 |
| Bronchoscopy with transbronchial lung biopsy CPT 31628 • Pulmonology | $44 | $123 | $237 |
| Bronchoscopy with endobronchial ultrasound biopsy CPT 31652 • Pulmonology | $309 | $702 | $1,095 |
| Ventilation assist and management initiation CPT 94002 • Pulmonology | $89 | $97 | $113 |
| Spirometry CPT 94010 • Pulmonology | $5 | $24 | $44 |
| Spirometry before and after bronchodilator CPT 94060 • Pulmonology | $40 | $57 | $74 |
| Bronchospasm provocation evaluation CPT 94070 • Pulmonology | $13 | $25 | $38 |
| Respiratory flow volume loop CPT 94375 • Pulmonology | $8 | $17 | $25 |
| Cardiopulmonary exercise test CPT 94621 • Pulmonology | $79 | $138 | $198 |
| Nebulizer inhalation treatment CPT 94640 • Pulmonology | $12 | $17 | $22 |
| Aerosol or vapor inhalation initial demonstration CPT 94664 • Pulmonology | $4 | $12 | $21 |
| Plethysmography lung volumes CPT 94726 • Pulmonology | $44 | $54 | $64 |
| Gas dilution lung volumes CPT 94727 • Pulmonology | $45 | $47 | $51 |