| Spirometry before and after bronchodilator CPT 94060 • Pulmonology | $15 | $15 | $15 |
| Bronchospasm provocation evaluation CPT 94070 • Pulmonology | $19 | $19 | $19 |
| Respiratory flow volume loop CPT 94375 • Pulmonology | $20 | $20 | $20 |
| Cardiopulmonary exercise test CPT 94621 • Pulmonology | $80 | $80 | $80 |
| Nebulizer inhalation treatment CPT 94640 • Pulmonology | $4 | $4 | $4 |
| Aerosol or vapor inhalation initial demonstration CPT 94664 • Pulmonology | $9 | $9 | $9 |
| Plethysmography lung volumes CPT 94726 • Pulmonology | $29 | $29 | $29 |
| Gas dilution lung volumes CPT 94727 • Pulmonology | $6 | $6 | $6 |
| Diffusing capacity (DLCO) CPT 94729 • Pulmonology | $29 | $29 | $29 |
| Pulse oximetry single measurement CPT 94760 • Pulmonology | $0 | $0 | $0 |
| Pulse oximetry continuous overnight CPT 94762 • Pulmonology | $13 | $13 | $13 |
| Radiation therapy planning simple CPT 77261 • Radiation Therapy | $36 | $36 | $36 |
| Radiation therapy planning intermediate CPT 77262 • Radiation Therapy | $56 | $56 | $56 |
| Radiation therapy planning complex CPT 77263 • Radiation Therapy | $87 | $87 | $87 |
| Radiation therapy simulation simple CPT 77280 • Radiation Therapy | $140 | $140 | $140 |
| Radiation therapy simulation complex CPT 77290 • Radiation Therapy | $232 | $232 | $232 |
| 3-dimensional radiation therapy plan CPT 77295 • Radiation Therapy | $249 | $249 | $249 |
| Radiation therapy dose calculation CPT 77300 • Radiation Therapy | $51 | $51 | $51 |
| IMRT radiation therapy plan CPT 77301 • Radiation Therapy | $1,436 | $1,436 | $1,436 |
| Radiation treatment device design complex CPT 77334 • Radiation Therapy | $98 | $98 | $98 |
| Radiation physics consultation CPT 77336 • Radiation Therapy | $69 | $69 | $69 |
| Stereotactic radiosurgery (SRS) cranial CPT 77371 • Radiation Therapy | $544 | $544 | $544 |
| Stereotactic body radiation therapy (SBRT) CPT 77373 • Radiation Therapy | $516 | $516 | $516 |
| Radiation treatment delivery superficial CPT 77407 • Radiation Therapy | $146 | $146 | $146 |
| Radiation treatment delivery 3 or more MeV CPT 77412 • Radiation Therapy | $115 | $115 | $115 |
| Radiation treatment management 5 treatments CPT 77427 • Radiation Therapy | $99 | $99 | $99 |
| Radiation therapy management complete course CPT 77431 • Radiation Therapy | $56 | $56 | $56 |
| Proton beam treatment simple CPT 77520 • Radiation Therapy | $155 | $155 | $155 |
| Proton beam treatment complex CPT 77523 • Radiation Therapy | $406 | $406 | $406 |
| Polysomnography under age 6 CPT 95782 • Sleep Medicine | $63 | $63 | $63 |
| Polysomnography under age 6 with CPAP CPT 95783 • Sleep Medicine | $68 | $68 | $68 |
| Sleep study unattended CPT 95800 • Sleep Medicine | $20 | $20 | $20 |
| Sleep study unattended minimum 3 channels CPT 95801 • Sleep Medicine | $30 | $30 | $30 |
| Multiple sleep latency test (MSLT) CPT 95805 • Sleep Medicine | $195 | $195 | $195 |
| Polysomnography age 6 or older CPT 95810 • Sleep Medicine | $60 | $60 | $60 |
| Polysomnography with CPAP titration CPT 95811 • Sleep Medicine | $338 | $338 | $338 |
| CPAP combination oral/nasal mask HCPCS A7027 • Sleep Medicine | $53 | $53 | $53 |
| Respiratory assist device BiPAP without backup HCPCS E0470 • Sleep Medicine | $46 | $46 | $46 |
| CPAP device continuous positive airway pressure HCPCS E0601 • Sleep Medicine | $176 | $176 | $176 |
| Laparoscopic partial nephrectomy CPT 50543 • Urology | $122 | $122 | $122 |
| Laparoscopic radical nephrectomy CPT 50545 • Urology | $110 | $110 | $110 |
| Lithotripsy extracorporeal shock wave (ESWL) CPT 50590 • Urology | $577 | $577 | $577 |
| Complex uroflowmetry CPT 51741 • Urology | $11 | $11 | $11 |
| Post-void residual urine measurement CPT 51798 • Urology | $4 | $4 | $4 |
| Cystourethroscopy diagnostic CPT 52000 • Urology | $186 | $186 | $186 |
| Cystourethroscopy with tumor fulguration small CPT 52234 • Urology | $188 | $188 | $188 |
| Cystourethroscopy with tumor fulguration medium CPT 52235 • Urology | $93 | $93 | $93 |
| Cystourethroscopy with dilation of ureteral stricture CPT 52260 • Urology | $161 | $161 | $161 |
| Cystourethroscopy with ureteral stent insertion CPT 52332 • Urology | $119 | $119 | $119 |
| Cystourethroscopy with lithotripsy CPT 52353 • Urology | $299 | $299 | $299 |