| Immunization admin first vaccine component CPT 90460 • Preventive Care | $10 | $13 | $20 |
| Immunization admin each additional component CPT 90461 • Preventive Care | $5 | $6 | $7 |
| Immunization admin injection single CPT 90471 • Preventive Care | $2 | $11 | $19 |
| Immunization admin injection each additional CPT 90472 • Preventive Care | $6 | $23 | $53 |
| HPV vaccine 9-valent CPT 90651 • Preventive Care | $67 | $364 | $661 |
| Pneumococcal conjugate vaccine 13-valent CPT 90670 • Preventive Care | $230 | $240 | $258 |
| Rotavirus vaccine pentavalent CPT 90680 • Preventive Care | $10 | $72 | $104 |
| Influenza vaccine quadrivalent preservative free CPT 90686 • Preventive Care | $10 | $17 | $22 |
| MMR vaccine CPT 90707 • Preventive Care | $52 | $115 | $194 |
| Tdap vaccine age 7 years or older CPT 90715 • Preventive Care | $39 | $59 | $100 |
| Varicella vaccine CPT 90716 • Preventive Care | $98 | $162 | $195 |
| Pneumococcal vaccine adult CPT 90732 • Preventive Care | $27 | $132 | $235 |
| Zoster vaccine recombinant adjuvanted CPT 90750 • Preventive Care | $24 | $120 | $216 |
| Preventive visit new patient infant CPT 99381 • Preventive Care | $63 | $119 | $187 |
| Preventive visit new patient age 1-4 CPT 99382 • Preventive Care | $36 | $117 | $200 |
| Preventive visit new patient age 5-11 CPT 99383 • Preventive Care | $7 | $75 | $113 |
| Preventive visit new patient age 12-17 CPT 99384 • Preventive Care | $12 | $174 | $335 |
| Preventive visit new patient age 18-39 CPT 99385 • Preventive Care | $36 | $125 | $241 |
| Preventive visit new patient age 40-64 CPT 99386 • Preventive Care | $44 | $178 | $375 |
| Preventive visit new patient age 65+ CPT 99387 • Preventive Care | $88 | $112 | $124 |
| Preventive visit established patient infant CPT 99391 • Preventive Care | $85 | $165 | $246 |
| Preventive visit established patient age 1-4 CPT 99392 • Preventive Care | $67 | $127 | $187 |
| Preventive visit established patient age 5-11 CPT 99393 • Preventive Care | $6 | $133 | $259 |
| Preventive visit established patient age 12-17 CPT 99394 • Preventive Care | $71 | $86 | $101 |
| Preventive visit established patient age 18-39 CPT 99395 • Preventive Care | $10 | $151 | $292 |
| Preventive visit established patient age 40-64 CPT 99396 • Preventive Care | $94 | $99 | $109 |
| Preventive visit established patient age 65+ CPT 99397 • Preventive Care | $15 | $175 | $335 |
| Cervical or vaginal cancer screening pelvic exam HCPCS G0101 • Preventive Care | $2 | $15 | $23 |
| Colorectal cancer screening flexible sigmoidoscopy HCPCS G0104 • Preventive Care | $5 | $93 | $181 |
| Colorectal cancer screening colonoscopy high risk HCPCS G0105 • Preventive Care | $60 | $165 | $317 |
| Colorectal cancer screening colonoscopy not high risk HCPCS G0121 • Preventive Care | $24 | $468 | $912 |
| Initial preventive physical exam (Welcome to Medicare) HCPCS G0402 • Preventive Care | $100 | $116 | $147 |
| Annual wellness visit initial HCPCS G0438 • Preventive Care | $103 | $205 | $409 |
| Annual wellness visit subsequent HCPCS G0439 • Preventive Care | $70 | $86 | $116 |
| Bronchoscopy diagnostic CPT 31622 • Pulmonology | $64 | $348 | $661 |
| Bronchoscopy with brushing CPT 31623 • Pulmonology | $76 | $383 | $730 |
| Bronchoscopy with bronchial alveolar lavage CPT 31624 • Pulmonology | $76 | $361 | $682 |
| Bronchoscopy with biopsy CPT 31625 • Pulmonology | $26 | $258 | $413 |
| Bronchoscopy with transbronchial lung biopsy CPT 31628 • Pulmonology | $42 | $154 | $355 |
| Bronchoscopy with endobronchial ultrasound biopsy CPT 31652 • Pulmonology | $168 | $609 | $947 |
| Ventilation assist and management initiation CPT 94002 • Pulmonology | $70 | $77 | $80 |
| Spirometry CPT 94010 • Pulmonology | $6 | $21 | $32 |
| Spirometry before and after bronchodilator CPT 94060 • Pulmonology | $37 | $44 | $54 |
| Bronchospasm provocation evaluation CPT 94070 • Pulmonology | $23 | $34 | $52 |
| Respiratory flow volume loop CPT 94375 • Pulmonology | $17 | $55 | $107 |
| Cardiopulmonary exercise test CPT 94621 • Pulmonology | $143 | $242 | $439 |
| Nebulizer inhalation treatment CPT 94640 • Pulmonology | $8 | $22 | $42 |
| Aerosol or vapor inhalation initial demonstration CPT 94664 • Pulmonology | $8 | $13 | $17 |
| Plethysmography lung volumes CPT 94726 • Pulmonology | $46 | $70 | $116 |
| Gas dilution lung volumes CPT 94727 • Pulmonology | $32 | $36 | $37 |