| Immunization admin first vaccine component CPT 90460 • Preventive Care | $10 | $11 | $13 |
| Immunization admin each additional component CPT 90461 • Preventive Care | $5 | $7 | $11 |
| Immunization admin injection single CPT 90471 • Preventive Care | $1 | $7 | $12 |
| Immunization admin injection each additional CPT 90472 • Preventive Care | $10 | $11 | $11 |
| HPV vaccine 9-valent CPT 90651 • Preventive Care | $79 | $225 | $371 |
| Pneumococcal conjugate vaccine 13-valent CPT 90670 • Preventive Care | $230 | $264 | $292 |
| Rotavirus vaccine pentavalent CPT 90680 • Preventive Care | $62 | $84 | $105 |
| Influenza vaccine quadrivalent preservative free CPT 90686 • Preventive Care | $4 | $13 | $21 |
| MMR vaccine CPT 90707 • Preventive Care | $21 | $60 | $100 |
| Tdap vaccine age 7 years or older CPT 90715 • Preventive Care | $6 | $31 | $56 |
| Varicella vaccine CPT 90716 • Preventive Care | $98 | $140 | $182 |
| Pneumococcal vaccine adult CPT 90732 • Preventive Care | $20 | $94 | $140 |
| Zoster vaccine recombinant adjuvanted CPT 90750 • Preventive Care | $239 | $247 | $258 |
| Preventive visit new patient infant CPT 99381 • Preventive Care | $36 | $68 | $100 |
| Preventive visit new patient age 1-4 CPT 99382 • Preventive Care | $7 | $41 | $76 |
| Preventive visit new patient age 5-11 CPT 99383 • Preventive Care | $40 | $54 | $67 |
| Preventive visit new patient age 12-17 CPT 99384 • Preventive Care | $13 | $54 | $95 |
| Preventive visit new patient age 18-39 CPT 99385 • Preventive Care | $46 | $130 | $214 |
| Preventive visit new patient age 40-64 CPT 99386 • Preventive Care | $19 | $133 | $247 |
| Preventive visit new patient age 65+ CPT 99387 • Preventive Care | $119 | $123 | $128 |
| Preventive visit established patient infant CPT 99391 • Preventive Care | $8 | $68 | $115 |
| Preventive visit established patient age 1-4 CPT 99392 • Preventive Care | $44 | $84 | $125 |
| Preventive visit established patient age 5-11 CPT 99393 • Preventive Care | $16 | $91 | $171 |
| Preventive visit established patient age 12-17 CPT 99394 • Preventive Care | $14 | $58 | $89 |
| Preventive visit established patient age 18-39 CPT 99395 • Preventive Care | $11 | $59 | $108 |
| Preventive visit established patient age 40-64 CPT 99396 • Preventive Care | $78 | $118 | $158 |
| Preventive visit established patient age 65+ CPT 99397 • Preventive Care | $47 | $86 | $124 |
| Cervical or vaginal cancer screening pelvic exam HCPCS G0101 • Preventive Care | $4 | $13 | $22 |
| Colorectal cancer screening flexible sigmoidoscopy HCPCS G0104 • Preventive Care | $4 | $79 | $154 |
| Colorectal cancer screening colonoscopy high risk HCPCS G0105 • Preventive Care | $59 | $178 | $297 |
| Colorectal cancer screening colonoscopy not high risk HCPCS G0121 • Preventive Care | $39 | $288 | $538 |
| Initial preventive physical exam (Welcome to Medicare) HCPCS G0402 • Preventive Care | $179 | $187 | $204 |
| Annual wellness visit initial HCPCS G0438 • Preventive Care | $109 | $164 | $273 |
| Annual wellness visit subsequent HCPCS G0439 • Preventive Care | $88 | $123 | $140 |
| Bronchoscopy diagnostic CPT 31622 • Pulmonology | $103 | $108 | $113 |
| Bronchoscopy with brushing CPT 31623 • Pulmonology | $241 | $246 | $252 |
| Bronchoscopy with bronchial alveolar lavage CPT 31624 • Pulmonology | $15 | $121 | $226 |
| Bronchoscopy with biopsy CPT 31625 • Pulmonology | $214 | $235 | $256 |
| Bronchoscopy with transbronchial lung biopsy CPT 31628 • Pulmonology | $19 | $163 | $282 |
| Bronchoscopy with endobronchial ultrasound biopsy CPT 31652 • Pulmonology | $155 | $500 | $846 |
| Ventilation assist and management initiation CPT 94002 • Pulmonology | $71 | $80 | $84 |
| Spirometry CPT 94010 • Pulmonology | $13 | $14 | $14 |
| Spirometry before and after bronchodilator CPT 94060 • Pulmonology | $10 | $15 | $19 |
| Bronchospasm provocation evaluation CPT 94070 • Pulmonology | $22 | $41 | $60 |
| Respiratory flow volume loop CPT 94375 • Pulmonology | $8 | $24 | $39 |
| Cardiopulmonary exercise test CPT 94621 • Pulmonology | $76 | $83 | $89 |
| Nebulizer inhalation treatment CPT 94640 • Pulmonology | $2 | $9 | $14 |
| Aerosol or vapor inhalation initial demonstration CPT 94664 • Pulmonology | $18 | $22 | $27 |
| Plethysmography lung volumes CPT 94726 • Pulmonology | $9 | $18 | $27 |
| Gas dilution lung volumes CPT 94727 • Pulmonology | $12 | $25 | $44 |