| Immunization admin first vaccine component CPT 90460 • Preventive Care | $24 | $25 | $27 |
| Immunization admin each additional component CPT 90461 • Preventive Care | $12 | $13 | $14 |
| Immunization admin injection single CPT 90471 • Preventive Care | $14 | $16 | $18 |
| Immunization admin injection each additional CPT 90472 • Preventive Care | $10 | $12 | $14 |
| HPV vaccine 9-valent CPT 90651 • Preventive Care | $369 | $382 | $395 |
| Pneumococcal conjugate vaccine 13-valent CPT 90670 • Preventive Care | $254 | $263 | $272 |
| Rotavirus vaccine pentavalent CPT 90680 • Preventive Care | $115 | $119 | $123 |
| Influenza vaccine quadrivalent preservative free CPT 90686 • Preventive Care | $5 | $14 | $24 |
| MMR vaccine CPT 90707 • Preventive Care | $107 | $112 | $117 |
| Tdap vaccine age 7 years or older CPT 90715 • Preventive Care | $55 | $57 | $59 |
| Varicella vaccine CPT 90716 • Preventive Care | $215 | $223 | $230 |
| Pneumococcal vaccine adult CPT 90732 • Preventive Care | $131 | $136 | $141 |
| Zoster vaccine recombinant adjuvanted CPT 90750 • Preventive Care | $241 | $262 | $282 |
| Preventive visit new patient infant CPT 99381 • Preventive Care | $94 | $101 | $109 |
| Preventive visit new patient age 1-4 CPT 99382 • Preventive Care | $78 | $90 | $101 |
| Preventive visit new patient age 5-11 CPT 99383 • Preventive Care | $78 | $89 | $100 |
| Preventive visit new patient age 12-17 CPT 99384 • Preventive Care | $5 | $41 | $76 |
| Preventive visit new patient age 18-39 CPT 99385 • Preventive Care | $5 | $41 | $76 |
| Preventive visit new patient age 40-64 CPT 99386 • Preventive Care | $5 | $66 | $127 |
| Preventive visit new patient age 65+ CPT 99387 • Preventive Care | $139 | $149 | $160 |
| Preventive visit established patient infant CPT 99391 • Preventive Care | $5 | $40 | $75 |
| Preventive visit established patient age 1-4 CPT 99392 • Preventive Care | $59 | $76 | $93 |
| Preventive visit established patient age 5-11 CPT 99393 • Preventive Care | $59 | $64 | $68 |
| Preventive visit established patient age 12-17 CPT 99394 • Preventive Care | $91 | $97 | $102 |
| Preventive visit established patient age 18-39 CPT 99395 • Preventive Care | $92 | $97 | $103 |
| Preventive visit established patient age 40-64 CPT 99396 • Preventive Care | $5 | $53 | $101 |
| Preventive visit established patient age 65+ CPT 99397 • Preventive Care | $5 | $59 | $113 |
| Cervical or vaginal cancer screening pelvic exam HCPCS G0101 • Preventive Care | $37 | $37 | $37 |
| Colorectal cancer screening flexible sigmoidoscopy HCPCS G0104 • Preventive Care | $131 | $131 | $131 |
| Colorectal cancer screening colonoscopy high risk HCPCS G0105 • Preventive Care | $208 | $208 | $208 |
| Colorectal cancer screening colonoscopy not high risk HCPCS G0121 • Preventive Care | $387 | $387 | $387 |
| Initial preventive physical exam (Welcome to Medicare) HCPCS G0402 • Preventive Care | $102 | $102 | $102 |
| Annual wellness visit initial HCPCS G0438 • Preventive Care | $190 | $190 | $190 |
| Annual wellness visit subsequent HCPCS G0439 • Preventive Care | $127 | $127 | $127 |
| Bronchoscopy diagnostic CPT 31622 • Pulmonology | $177 | $248 | $318 |
| Bronchoscopy with brushing CPT 31623 • Pulmonology | $350 | $378 | $406 |
| Bronchoscopy with bronchial alveolar lavage CPT 31624 • Pulmonology | $180 | $252 | $325 |
| Bronchoscopy with biopsy CPT 31625 • Pulmonology | $172 | $191 | $210 |
| Bronchoscopy with transbronchial lung biopsy CPT 31628 • Pulmonology | $192 | $333 | $474 |
| Bronchoscopy with endobronchial ultrasound biopsy CPT 31652 • Pulmonology | $294 | $649 | $1,004 |
| Ventilation assist and management initiation CPT 94002 • Pulmonology | $89 | $89 | $90 |
| Spirometry CPT 94010 • Pulmonology | $26 | $30 | $34 |
| Spirometry before and after bronchodilator CPT 94060 • Pulmonology | $15 | $27 | $39 |
| Bronchospasm provocation evaluation CPT 94070 • Pulmonology | $27 | $44 | $60 |
| Respiratory flow volume loop CPT 94375 • Pulmonology | $23 | $30 | $37 |
| Cardiopulmonary exercise test CPT 94621 • Pulmonology | $78 | $84 | $90 |
| Nebulizer inhalation treatment CPT 94640 • Pulmonology | $12 | $13 | $14 |
| Aerosol or vapor inhalation initial demonstration CPT 94664 • Pulmonology | $13 | $14 | $15 |
| Plethysmography lung volumes CPT 94726 • Pulmonology | $15 | $15 | $15 |
| Gas dilution lung volumes CPT 94727 • Pulmonology | $48 | $48 | $49 |