| Immunization admin first vaccine component CPT 90460 • Preventive Care | $22 | $23 | $24 |
| Immunization admin each additional component CPT 90461 • Preventive Care | $11 | $12 | $12 |
| Immunization admin injection single CPT 90471 • Preventive Care | $8 | $12 | $19 |
| Immunization admin injection each additional CPT 90472 • Preventive Care | $5 | $7 | $10 |
| HPV vaccine 9-valent CPT 90651 • Preventive Care | $329 | $349 | $369 |
| Pneumococcal conjugate vaccine 13-valent CPT 90670 • Preventive Care | $114 | $171 | $258 |
| Rotavirus vaccine pentavalent CPT 90680 • Preventive Care | $70 | $85 | $115 |
| Influenza vaccine quadrivalent preservative free CPT 90686 • Preventive Care | $5 | $14 | $22 |
| MMR vaccine CPT 90707 • Preventive Care | $5 | $61 | $107 |
| Tdap vaccine age 7 years or older CPT 90715 • Preventive Care | $39 | $45 | $55 |
| Varicella vaccine CPT 90716 • Preventive Care | $17 | $119 | $215 |
| Pneumococcal vaccine adult CPT 90732 • Preventive Care | $53 | $81 | $131 |
| Zoster vaccine recombinant adjuvanted CPT 90750 • Preventive Care | $216 | $228 | $241 |
| Preventive visit new patient infant CPT 99381 • Preventive Care | $5 | $43 | $81 |
| Preventive visit new patient age 1-4 CPT 99382 • Preventive Care | $64 | $72 | $89 |
| Preventive visit new patient age 5-11 CPT 99383 • Preventive Care | $62 | $70 | $78 |
| Preventive visit new patient age 12-17 CPT 99384 • Preventive Care | $72 | $100 | $125 |
| Preventive visit new patient age 18-39 CPT 99385 • Preventive Care | $88 | $98 | $104 |
| Preventive visit new patient age 40-64 CPT 99386 • Preventive Care | $86 | $112 | $121 |
| Preventive visit new patient age 65+ CPT 99387 • Preventive Care | $5 | $64 | $124 |
| Preventive visit established patient infant CPT 99391 • Preventive Care | $5 | $37 | $68 |
| Preventive visit established patient age 1-4 CPT 99392 • Preventive Care | $68 | $72 | $76 |
| Preventive visit established patient age 5-11 CPT 99393 • Preventive Care | $56 | $62 | $76 |
| Preventive visit established patient age 12-17 CPT 99394 • Preventive Care | $5 | $60 | $85 |
| Preventive visit established patient age 18-39 CPT 99395 • Preventive Care | $64 | $78 | $86 |
| Preventive visit established patient age 40-64 CPT 99396 • Preventive Care | $70 | $75 | $88 |
| Preventive visit established patient age 65+ CPT 99397 • Preventive Care | $5 | $42 | $78 |
| Cervical or vaginal cancer screening pelvic exam HCPCS G0101 • Preventive Care | $31 | $31 | $31 |
| Colorectal cancer screening flexible sigmoidoscopy HCPCS G0104 • Preventive Care | $54 | $54 | $54 |
| Colorectal cancer screening colonoscopy high risk HCPCS G0105 • Preventive Care | $190 | $190 | $190 |
| Colorectal cancer screening colonoscopy not high risk HCPCS G0121 • Preventive Care | $190 | $190 | $190 |
| Initial preventive physical exam (Welcome to Medicare) HCPCS G0402 • Preventive Care | $120 | $120 | $120 |
| Annual wellness visit initial HCPCS G0438 • Preventive Care | $153 | $153 | $153 |
| Annual wellness visit subsequent HCPCS G0439 • Preventive Care | $103 | $103 | $103 |
| Bronchoscopy diagnostic CPT 31622 • Pulmonology | $265 | $317 | $370 |
| Bronchoscopy with brushing CPT 31623 • Pulmonology | $131 | $268 | $406 |
| Bronchoscopy with bronchial alveolar lavage CPT 31624 • Pulmonology | $131 | $255 | $378 |
| Bronchoscopy with biopsy CPT 31625 • Pulmonology | $152 | $181 | $210 |
| Bronchoscopy with transbronchial lung biopsy CPT 31628 • Pulmonology | $169 | $322 | $474 |
| Bronchoscopy with endobronchial ultrasound biopsy CPT 31652 • Pulmonology | $217 | $256 | $294 |
| Ventilation assist and management initiation CPT 94002 • Pulmonology | $81 | $85 | $90 |
| Spirometry CPT 94010 • Pulmonology | $7 | $8 | $9 |
| Spirometry before and after bronchodilator CPT 94060 • Pulmonology | $50 | $53 | $56 |
| Bronchospasm provocation evaluation CPT 94070 • Pulmonology | $33 | $42 | $51 |
| Respiratory flow volume loop CPT 94375 • Pulmonology | $17 | $18 | $19 |
| Cardiopulmonary exercise test CPT 94621 • Pulmonology | $140 | $144 | $148 |
| Nebulizer inhalation treatment CPT 94640 • Pulmonology | $12 | $12 | $12 |
| Aerosol or vapor inhalation initial demonstration CPT 94664 • Pulmonology | $12 | $13 | $13 |
| Plethysmography lung volumes CPT 94726 • Pulmonology | $50 | $56 | $61 |
| Gas dilution lung volumes CPT 94727 • Pulmonology | $15 | $21 | $28 |