| Preventive visit established patient age 18-39 CPT 99395 • Preventive Care | $94 | $105 | $116 |
| Preventive visit established patient age 40-64 CPT 99396 • Preventive Care | $123 | $129 | $135 |
| Preventive visit established patient age 65+ CPT 99397 • Preventive Care | $109 | $121 | $133 |
| Colorectal cancer screening colonoscopy high risk HCPCS G0105 • Preventive Care | $235 | $235 | $235 |
| Colorectal cancer screening colonoscopy not high risk HCPCS G0121 • Preventive Care | $195 | $195 | $195 |
| Annual wellness visit initial HCPCS G0438 • Preventive Care | $130 | $130 | $130 |
| Annual wellness visit subsequent HCPCS G0439 • Preventive Care | $103 | $121 | $140 |
| Bronchoscopy with transbronchial lung biopsy CPT 31628 • Pulmonology | $139 | $139 | $139 |
| Spirometry CPT 94010 • Pulmonology | $7 | $20 | $33 |
| Spirometry before and after bronchodilator CPT 94060 • Pulmonology | $32 | $32 | $32 |
| Respiratory flow volume loop CPT 94375 • Pulmonology | $32 | $32 | $32 |
| Nebulizer inhalation treatment CPT 94640 • Pulmonology | $7 | $20 | $33 |
| Aerosol or vapor inhalation initial demonstration CPT 94664 • Pulmonology | $17 | $17 | $17 |
| Plethysmography lung volumes CPT 94726 • Pulmonology | $11 | $11 | $11 |
| Diffusing capacity (DLCO) CPT 94729 • Pulmonology | $46 | $46 | $46 |
| Pulse oximetry continuous overnight CPT 94762 • Pulmonology | $20 | $20 | $20 |
| Sleep study unattended CPT 95800 • Sleep Medicine | $124 | $124 | $124 |
| Polysomnography age 6 or older CPT 95810 • Sleep Medicine | $528 | $528 | $528 |
| Polysomnography with CPAP titration CPT 95811 • Sleep Medicine | $553 | $553 | $553 |
| Respiratory assist device BiPAP without backup HCPCS E0470 • Sleep Medicine | $82 | $82 | $82 |
| CPAP device continuous positive airway pressure HCPCS E0601 • Sleep Medicine | $90 | $90 | $90 |
| Lithotripsy extracorporeal shock wave (ESWL) CPT 50590 • Urology | $504 | $504 | $504 |
| Complex uroflowmetry CPT 51741 • Urology | $6 | $6 | $6 |
| Post-void residual urine measurement CPT 51798 • Urology | $11 | $11 | $11 |
| Cystourethroscopy diagnostic CPT 52000 • Urology | $193 | $193 | $193 |
| Cystourethroscopy with ureteral stent insertion CPT 52332 • Urology | $126 | $126 | $126 |
| TURP transurethral resection of prostate CPT 52601 • Urology | $639 | $639 | $639 |
| Vasectomy CPT 55250 • Urology | $289 | $289 | $289 |
| Prostate biopsy needle or punch CPT 55700 • Urology | $209 | $209 | $209 |
| Laparoscopic radical prostatectomy CPT 55866 • Urology | $167 | $167 | $167 |