| Immunization admin first vaccine component CPT 90460 • Preventive Care | $17 | $22 | $37 |
| Immunization admin each additional component CPT 90461 • Preventive Care | $7 | $10 | $17 |
| Immunization admin injection single CPT 90471 • Preventive Care | $2 | $11 | $19 |
| Immunization admin injection each additional CPT 90472 • Preventive Care | $2 | $15 | $33 |
| HPV vaccine 9-valent CPT 90651 • Preventive Care | $329 | $336 | $344 |
| Pneumococcal conjugate vaccine 13-valent CPT 90670 • Preventive Care | $230 | $251 | $292 |
| Rotavirus vaccine pentavalent CPT 90680 • Preventive Care | $52 | $93 | $115 |
| Influenza vaccine quadrivalent preservative free CPT 90686 • Preventive Care | $4 | $15 | $22 |
| MMR vaccine CPT 90707 • Preventive Care | $10 | $81 | $109 |
| Tdap vaccine age 7 years or older CPT 90715 • Preventive Care | $6 | $41 | $70 |
| Varicella vaccine CPT 90716 • Preventive Care | $39 | $156 | $199 |
| Pneumococcal vaccine adult CPT 90732 • Preventive Care | $132 | $133 | $133 |
| Zoster vaccine recombinant adjuvanted CPT 90750 • Preventive Care | $221 | $235 | $244 |
| Preventive visit new patient infant CPT 99381 • Preventive Care | $41 | $125 | $214 |
| Preventive visit new patient age 1-4 CPT 99382 • Preventive Care | $37 | $125 | $201 |
| Preventive visit new patient age 5-11 CPT 99383 • Preventive Care | $50 | $107 | $164 |
| Preventive visit new patient age 12-17 CPT 99384 • Preventive Care | $18 | $106 | $186 |
| Preventive visit new patient age 18-39 CPT 99385 • Preventive Care | $98 | $128 | $180 |
| Preventive visit new patient age 40-64 CPT 99386 • Preventive Care | $57 | $200 | $333 |
| Preventive visit new patient age 65+ CPT 99387 • Preventive Care | $114 | $157 | $223 |
| Preventive visit established patient infant CPT 99391 • Preventive Care | $6 | $76 | $136 |
| Preventive visit established patient age 1-4 CPT 99392 • Preventive Care | $40 | $94 | $142 |
| Preventive visit established patient age 5-11 CPT 99393 • Preventive Care | $6 | $98 | $144 |
| Preventive visit established patient age 12-17 CPT 99394 • Preventive Care | $12 | $108 | $158 |
| Preventive visit established patient age 18-39 CPT 99395 • Preventive Care | $88 | $124 | $163 |
| Preventive visit established patient age 40-64 CPT 99396 • Preventive Care | $82 | $167 | $338 |
| Preventive visit established patient age 65+ CPT 99397 • Preventive Care | $11 | $127 | $238 |
| Cervical or vaginal cancer screening pelvic exam HCPCS G0101 • Preventive Care | $19 | $46 | $75 |
| Colorectal cancer screening flexible sigmoidoscopy HCPCS G0104 • Preventive Care | $71 | $100 | $129 |
| Colorectal cancer screening colonoscopy high risk HCPCS G0105 • Preventive Care | $202 | $229 | $252 |
| Colorectal cancer screening colonoscopy not high risk HCPCS G0121 • Preventive Care | $89 | $213 | $293 |
| Initial preventive physical exam (Welcome to Medicare) HCPCS G0402 • Preventive Care | $160 | $176 | $184 |
| Annual wellness visit initial HCPCS G0438 • Preventive Care | $147 | $182 | $209 |
| Annual wellness visit subsequent HCPCS G0439 • Preventive Care | $102 | $135 | $153 |
| Bronchoscopy diagnostic CPT 31622 • Pulmonology | $30 | $113 | $183 |
| Bronchoscopy with brushing CPT 31623 • Pulmonology | $24 | $142 | $374 |
| Bronchoscopy with bronchial alveolar lavage CPT 31624 • Pulmonology | $34 | $164 | $271 |
| Bronchoscopy with biopsy CPT 31625 • Pulmonology | $30 | $192 | $482 |
| Bronchoscopy with transbronchial lung biopsy CPT 31628 • Pulmonology | $34 | $160 | $325 |
| Bronchoscopy with endobronchial ultrasound biopsy CPT 31652 • Pulmonology | $125 | $210 | $310 |
| Ventilation assist and management initiation CPT 94002 • Pulmonology | $83 | $103 | $127 |
| Spirometry CPT 94010 • Pulmonology | $9 | $21 | $37 |
| Spirometry before and after bronchodilator CPT 94060 • Pulmonology | $14 | $42 | $104 |
| Bronchospasm provocation evaluation CPT 94070 • Pulmonology | $22 | $39 | $63 |
| Respiratory flow volume loop CPT 94375 • Pulmonology | $11 | $29 | $52 |
| Cardiopulmonary exercise test CPT 94621 • Pulmonology | $30 | $149 | $222 |
| Nebulizer inhalation treatment CPT 94640 • Pulmonology | $5 | $17 | $30 |
| Aerosol or vapor inhalation initial demonstration CPT 94664 • Pulmonology | $5 | $14 | $21 |
| Plethysmography lung volumes CPT 94726 • Pulmonology | $11 | $24 | $56 |
| Gas dilution lung volumes CPT 94727 • Pulmonology | $17 | $33 | $60 |