| Immunization admin first vaccine component CPT 90460 • Preventive Care | $14 | $16 | $17 |
| Immunization admin each additional component CPT 90461 • Preventive Care | $8 | $10 | $13 |
| Immunization admin injection single CPT 90471 • Preventive Care | $1 | $8 | $14 |
| Immunization admin injection each additional CPT 90472 • Preventive Care | $2 | $7 | $13 |
| HPV vaccine 9-valent CPT 90651 • Preventive Care | $34 | $202 | $371 |
| Pneumococcal conjugate vaccine 13-valent CPT 90670 • Preventive Care | $231 | $261 | $292 |
| Rotavirus vaccine pentavalent CPT 90680 • Preventive Care | $52 | $84 | $115 |
| Influenza vaccine quadrivalent preservative free CPT 90686 • Preventive Care | $20 | $23 | $25 |
| MMR vaccine CPT 90707 • Preventive Care | $52 | $80 | $109 |
| Tdap vaccine age 7 years or older CPT 90715 • Preventive Care | $4 | $30 | $56 |
| Varicella vaccine CPT 90716 • Preventive Care | $20 | $118 | $217 |
| Pneumococcal vaccine adult CPT 90732 • Preventive Care | $20 | $76 | $132 |
| Zoster vaccine recombinant adjuvanted CPT 90750 • Preventive Care | $48 | $146 | $244 |
| Preventive visit new patient infant CPT 99381 • Preventive Care | $57 | $71 | $85 |
| Preventive visit new patient age 1-4 CPT 99382 • Preventive Care | $9 | $36 | $63 |
| Preventive visit new patient age 5-11 CPT 99383 • Preventive Care | $9 | $51 | $92 |
| Preventive visit new patient age 12-17 CPT 99384 • Preventive Care | $11 | $58 | $104 |
| Preventive visit new patient age 18-39 CPT 99385 • Preventive Care | $37 | $69 | $101 |
| Preventive visit new patient age 40-64 CPT 99386 • Preventive Care | $9 | $63 | $117 |
| Preventive visit new patient age 65+ CPT 99387 • Preventive Care | $18 | $73 | $127 |
| Preventive visit established patient infant CPT 99391 • Preventive Care | $74 | $75 | $76 |
| Preventive visit established patient age 1-4 CPT 99392 • Preventive Care | $12 | $47 | $81 |
| Preventive visit established patient age 5-11 CPT 99393 • Preventive Care | $79 | $80 | $81 |
| Preventive visit established patient age 12-17 CPT 99394 • Preventive Care | $65 | $66 | $67 |
| Preventive visit established patient age 18-39 CPT 99395 • Preventive Care | $88 | $90 | $91 |
| Preventive visit established patient age 40-64 CPT 99396 • Preventive Care | $94 | $96 | $97 |
| Preventive visit established patient age 65+ CPT 99397 • Preventive Care | $8 | $56 | $104 |
| Cervical or vaginal cancer screening pelvic exam HCPCS G0101 • Preventive Care | $6 | $14 | $22 |
| Colorectal cancer screening flexible sigmoidoscopy HCPCS G0104 • Preventive Care | $5 | $24 | $43 |
| Colorectal cancer screening colonoscopy high risk HCPCS G0105 • Preventive Care | $89 | $117 | $144 |
| Colorectal cancer screening colonoscopy not high risk HCPCS G0121 • Preventive Care | $89 | $172 | $255 |
| Initial preventive physical exam (Welcome to Medicare) HCPCS G0402 • Preventive Care | $126 | $129 | $131 |
| Annual wellness visit initial HCPCS G0438 • Preventive Care | $129 | $146 | $162 |
| Annual wellness visit subsequent HCPCS G0439 • Preventive Care | $88 | $107 | $127 |
| Bronchoscopy diagnostic CPT 31622 • Pulmonology | $23 | $104 | $186 |
| Bronchoscopy with brushing CPT 31623 • Pulmonology | $62 | $134 | $207 |
| Bronchoscopy with bronchial alveolar lavage CPT 31624 • Pulmonology | $125 | $159 | $193 |
| Bronchoscopy with biopsy CPT 31625 • Pulmonology | $66 | $165 | $265 |
| Bronchoscopy with transbronchial lung biopsy CPT 31628 • Pulmonology | $281 | $316 | $351 |
| Bronchoscopy with endobronchial ultrasound biopsy CPT 31652 • Pulmonology | $115 | $479 | $844 |
| Ventilation assist and management initiation CPT 94002 • Pulmonology | $71 | $79 | $86 |
| Spirometry CPT 94010 • Pulmonology | $21 | $24 | $27 |
| Spirometry before and after bronchodilator CPT 94060 • Pulmonology | $10 | $27 | $45 |
| Bronchospasm provocation evaluation CPT 94070 • Pulmonology | $22 | $39 | $57 |
| Respiratory flow volume loop CPT 94375 • Pulmonology | $7 | $18 | $30 |
| Cardiopulmonary exercise test CPT 94621 • Pulmonology | $68 | $106 | $144 |
| Nebulizer inhalation treatment CPT 94640 • Pulmonology | $2 | $8 | $14 |
| Aerosol or vapor inhalation initial demonstration CPT 94664 • Pulmonology | $3 | $8 | $13 |
| Plethysmography lung volumes CPT 94726 • Pulmonology | $31 | $34 | $38 |
| Gas dilution lung volumes CPT 94727 • Pulmonology | $9 | $19 | $28 |