| Immunization admin first vaccine component CPT 90460 • Preventive Care | $13 | $16 | $17 |
| Immunization admin each additional component CPT 90461 • Preventive Care | $8 | $9 | $12 |
| Immunization admin injection single CPT 90471 • Preventive Care | $5 | $9 | $13 |
| Immunization admin injection each additional CPT 90472 • Preventive Care | $5 | $9 | $12 |
| HPV vaccine 9-valent CPT 90651 • Preventive Care | $168 | $277 | $335 |
| Pneumococcal conjugate vaccine 13-valent CPT 90670 • Preventive Care | $230 | $240 | $258 |
| Rotavirus vaccine pentavalent CPT 90680 • Preventive Care | $21 | $76 | $104 |
| Influenza vaccine quadrivalent preservative free CPT 90686 • Preventive Care | $20 | $21 | $22 |
| MMR vaccine CPT 90707 • Preventive Care | $15 | $71 | $100 |
| Tdap vaccine age 7 years or older CPT 90715 • Preventive Care | $4 | $31 | $50 |
| Varicella vaccine CPT 90716 • Preventive Care | $192 | $194 | $196 |
| Pneumococcal vaccine adult CPT 90732 • Preventive Care | $27 | $72 | $117 |
| Zoster vaccine recombinant adjuvanted CPT 90750 • Preventive Care | $216 | $225 | $239 |
| Preventive visit new patient infant CPT 99381 • Preventive Care | $9 | $52 | $82 |
| Preventive visit new patient age 1-4 CPT 99382 • Preventive Care | $86 | $89 | $94 |
| Preventive visit new patient age 5-11 CPT 99383 • Preventive Care | $7 | $56 | $89 |
| Preventive visit new patient age 12-17 CPT 99384 • Preventive Care | $8 | $65 | $111 |
| Preventive visit new patient age 18-39 CPT 99385 • Preventive Care | $37 | $81 | $108 |
| Preventive visit new patient age 40-64 CPT 99386 • Preventive Care | $13 | $69 | $125 |
| Preventive visit new patient age 65+ CPT 99387 • Preventive Care | $12 | $81 | $122 |
| Preventive visit established patient infant CPT 99391 • Preventive Care | $52 | $56 | $59 |
| Preventive visit established patient age 1-4 CPT 99392 • Preventive Care | $9 | $51 | $87 |
| Preventive visit established patient age 5-11 CPT 99393 • Preventive Care | $29 | $58 | $86 |
| Preventive visit established patient age 12-17 CPT 99394 • Preventive Care | $9 | $41 | $73 |
| Preventive visit established patient age 18-39 CPT 99395 • Preventive Care | $13 | $55 | $97 |
| Preventive visit established patient age 40-64 CPT 99396 • Preventive Care | $9 | $69 | $104 |
| Preventive visit established patient age 65+ CPT 99397 • Preventive Care | $15 | $63 | $111 |
| Cervical or vaginal cancer screening pelvic exam HCPCS G0101 • Preventive Care | $26 | $32 | $37 |
| Colorectal cancer screening flexible sigmoidoscopy HCPCS G0104 • Preventive Care | $27 | $73 | $138 |
| Colorectal cancer screening colonoscopy high risk HCPCS G0105 • Preventive Care | $89 | $177 | $265 |
| Colorectal cancer screening colonoscopy not high risk HCPCS G0121 • Preventive Care | $33 | $94 | $155 |
| Initial preventive physical exam (Welcome to Medicare) HCPCS G0402 • Preventive Care | $105 | $133 | $162 |
| Annual wellness visit initial HCPCS G0438 • Preventive Care | $138 | $154 | $162 |
| Annual wellness visit subsequent HCPCS G0439 • Preventive Care | $93 | $116 | $127 |
| Bronchoscopy diagnostic CPT 31622 • Pulmonology | $110 | $154 | $228 |
| Bronchoscopy with brushing CPT 31623 • Pulmonology | $25 | $131 | $256 |
| Bronchoscopy with bronchial alveolar lavage CPT 31624 • Pulmonology | $94 | $111 | $125 |
| Bronchoscopy with biopsy CPT 31625 • Pulmonology | $146 | $251 | $329 |
| Bronchoscopy with transbronchial lung biopsy CPT 31628 • Pulmonology | $53 | $171 | $294 |
| Bronchoscopy with endobronchial ultrasound biopsy CPT 31652 • Pulmonology | $208 | $741 | $1,149 |
| Ventilation assist and management initiation CPT 94002 • Pulmonology | $78 | $83 | $86 |
| Spirometry CPT 94010 • Pulmonology | $7 | $15 | $26 |
| Spirometry before and after bronchodilator CPT 94060 • Pulmonology | $11 | $28 | $41 |
| Bronchospasm provocation evaluation CPT 94070 • Pulmonology | $24 | $46 | $57 |
| Respiratory flow volume loop CPT 94375 • Pulmonology | $12 | $23 | $35 |
| Cardiopulmonary exercise test CPT 94621 • Pulmonology | $29 | $80 | $143 |
| Nebulizer inhalation treatment CPT 94640 • Pulmonology | $6 | $10 | $14 |
| Aerosol or vapor inhalation initial demonstration CPT 94664 • Pulmonology | $13 | $14 | $15 |
| Plethysmography lung volumes CPT 94726 • Pulmonology | $42 | $47 | $49 |
| Gas dilution lung volumes CPT 94727 • Pulmonology | $10 | $23 | $40 |