| Immunization admin first vaccine component CPT 90460 • Preventive Care | $10 | $17 | $27 |
| Immunization admin each additional component CPT 90461 • Preventive Care | $5 | $8 | $13 |
| Immunization admin injection single CPT 90471 • Preventive Care | $1 | $8 | $14 |
| Immunization admin injection each additional CPT 90472 • Preventive Care | $6 | $9 | $13 |
| HPV vaccine 9-valent CPT 90651 • Preventive Care | $50 | $211 | $371 |
| Pneumococcal conjugate vaccine 13-valent CPT 90670 • Preventive Care | $231 | $249 | $271 |
| Rotavirus vaccine pentavalent CPT 90680 • Preventive Care | $62 | $88 | $115 |
| Influenza vaccine quadrivalent preservative free CPT 90686 • Preventive Care | $4 | $15 | $25 |
| MMR vaccine CPT 90707 • Preventive Care | $21 | $59 | $97 |
| Tdap vaccine age 7 years or older CPT 90715 • Preventive Care | $6 | $28 | $50 |
| Varicella vaccine CPT 90716 • Preventive Care | $196 | $206 | $217 |
| Pneumococcal vaccine adult CPT 90732 • Preventive Care | $27 | $69 | $111 |
| Zoster vaccine recombinant adjuvanted CPT 90750 • Preventive Care | $36 | $157 | $219 |
| Preventive visit new patient infant CPT 99381 • Preventive Care | $59 | $76 | $92 |
| Preventive visit new patient age 1-4 CPT 99382 • Preventive Care | $14 | $49 | $84 |
| Preventive visit new patient age 5-11 CPT 99383 • Preventive Care | $10 | $46 | $82 |
| Preventive visit new patient age 12-17 CPT 99384 • Preventive Care | $66 | $103 | $140 |
| Preventive visit new patient age 18-39 CPT 99385 • Preventive Care | $9 | $85 | $160 |
| Preventive visit new patient age 40-64 CPT 99386 • Preventive Care | $22 | $107 | $191 |
| Preventive visit new patient age 65+ CPT 99387 • Preventive Care | $20 | $113 | $206 |
| Preventive visit established patient infant CPT 99391 • Preventive Care | $8 | $37 | $66 |
| Preventive visit established patient age 1-4 CPT 99392 • Preventive Care | $36 | $79 | $123 |
| Preventive visit established patient age 5-11 CPT 99393 • Preventive Care | $9 | $66 | $123 |
| Preventive visit established patient age 12-17 CPT 99394 • Preventive Care | $12 | $98 | $188 |
| Preventive visit established patient age 18-39 CPT 99395 • Preventive Care | $13 | $41 | $69 |
| Preventive visit established patient age 40-64 CPT 99396 • Preventive Care | $12 | $44 | $75 |
| Preventive visit established patient age 65+ CPT 99397 • Preventive Care | $82 | $89 | $97 |
| Cervical or vaginal cancer screening pelvic exam HCPCS G0101 • Preventive Care | $17 | $24 | $31 |
| Colorectal cancer screening flexible sigmoidoscopy HCPCS G0104 • Preventive Care | $20 | $55 | $90 |
| Colorectal cancer screening colonoscopy high risk HCPCS G0105 • Preventive Care | $127 | $186 | $255 |
| Colorectal cancer screening colonoscopy not high risk HCPCS G0121 • Preventive Care | $118 | $131 | $145 |
| Initial preventive physical exam (Welcome to Medicare) HCPCS G0402 • Preventive Care | $86 | $152 | $262 |
| Annual wellness visit initial HCPCS G0438 • Preventive Care | $110 | $142 | $173 |
| Annual wellness visit subsequent HCPCS G0439 • Preventive Care | $88 | $94 | $97 |
| Bronchoscopy diagnostic CPT 31622 • Pulmonology | $76 | $152 | $227 |
| Bronchoscopy with brushing CPT 31623 • Pulmonology | $21 | $229 | $437 |
| Bronchoscopy with bronchial alveolar lavage CPT 31624 • Pulmonology | $59 | $207 | $408 |
| Bronchoscopy with biopsy CPT 31625 • Pulmonology | $44 | $155 | $265 |
| Bronchoscopy with transbronchial lung biopsy CPT 31628 • Pulmonology | $41 | $312 | $582 |
| Bronchoscopy with endobronchial ultrasound biopsy CPT 31652 • Pulmonology | $130 | $628 | $1,126 |
| Ventilation assist and management initiation CPT 94002 • Pulmonology | $71 | $81 | $89 |
| Spirometry CPT 94010 • Pulmonology | $8 | $13 | $18 |
| Spirometry before and after bronchodilator CPT 94060 • Pulmonology | $8 | $34 | $60 |
| Bronchospasm provocation evaluation CPT 94070 • Pulmonology | $28 | $36 | $45 |
| Respiratory flow volume loop CPT 94375 • Pulmonology | $14 | $21 | $25 |
| Cardiopulmonary exercise test CPT 94621 • Pulmonology | $67 | $105 | $143 |
| Nebulizer inhalation treatment CPT 94640 • Pulmonology | $17 | $23 | $28 |
| Aerosol or vapor inhalation initial demonstration CPT 94664 • Pulmonology | $13 | $15 | $18 |
| Plethysmography lung volumes CPT 94726 • Pulmonology | $13 | $22 | $31 |
| Gas dilution lung volumes CPT 94727 • Pulmonology | $21 | $47 | $69 |