| Sleep study unattended minimum 3 channels CPT 95801 • Sleep Medicine | $40 | $40 | $40 |
| Multiple sleep latency test (MSLT) CPT 95805 • Sleep Medicine | $169 | $254 | $339 |
| Polysomnography age 6 or older CPT 95810 • Sleep Medicine | $495 | $495 | $495 |
| CPAP combination oral/nasal mask HCPCS A7027 • Sleep Medicine | $153 | $153 | $154 |
| Respiratory assist device BiPAP without backup HCPCS E0470 • Sleep Medicine | $121 | $121 | $121 |
| CPAP device continuous positive airway pressure HCPCS E0601 • Sleep Medicine | $498 | $498 | $499 |
| Laparoscopic radical nephrectomy CPT 50545 • Urology | $1,301 | $1,301 | $1,301 |
| Lithotripsy extracorporeal shock wave (ESWL) CPT 50590 • Urology | $726 | $726 | $726 |
| Complex uroflowmetry CPT 51741 • Urology | $5 | $5 | $5 |
| Post-void residual urine measurement CPT 51798 • Urology | $9 | $9 | $9 |
| Cystourethroscopy with tumor fulguration small CPT 52234 • Urology | $238 | $238 | $238 |
| Cystourethroscopy with tumor fulguration medium CPT 52235 • Urology | $279 | $279 | $279 |
| Cystourethroscopy with dilation of ureteral stricture CPT 52260 • Urology | $204 | $204 | $204 |
| Cystourethroscopy with ureteral stent insertion CPT 52332 • Urology | $151 | $151 | $151 |
| Cystourethroscopy with lithotripsy CPT 52353 • Urology | $380 | $380 | $380 |
| TURP transurethral resection of prostate CPT 52601 • Urology | $710 | $710 | $710 |
| Laser vaporization of prostate CPT 52648 • Urology | $800 | $800 | $800 |
| Circumcision CPT 54150 • Urology | $146 | $146 | $146 |
| Orchiectomy radical inguinal CPT 54530 • Urology | $495 | $495 | $495 |
| Vasectomy CPT 55250 • Urology | $33 | $33 | $33 |
| Radical prostatectomy retropubic CPT 55840 • Urology | $1,140 | $1,140 | $1,140 |
| Laparoscopic radical prostatectomy CPT 55866 • Urology | $1,404 | $1,404 | $1,405 |