| Immunization admin first vaccine component CPT 90460 • Preventive Care | $12 | $17 | $24 |
| Immunization admin each additional component CPT 90461 • Preventive Care | $6 | $8 | $11 |
| Immunization admin injection single CPT 90471 • Preventive Care | $12 | $13 | $18 |
| Immunization admin injection each additional CPT 90472 • Preventive Care | $11 | $13 | $18 |
| HPV vaccine 9-valent CPT 90651 • Preventive Care | $268 | $311 | $336 |
| Pneumococcal conjugate vaccine 13-valent CPT 90670 • Preventive Care | $231 | $236 | $245 |
| Rotavirus vaccine pentavalent CPT 90680 • Preventive Care | $97 | $103 | $111 |
| Influenza vaccine quadrivalent preservative free CPT 90686 • Preventive Care | $19 | $20 | $21 |
| MMR vaccine CPT 90707 • Preventive Care | $15 | $75 | $100 |
| Tdap vaccine age 7 years or older CPT 90715 • Preventive Care | $34 | $41 | $47 |
| Varicella vaccine CPT 90716 • Preventive Care | $182 | $190 | $196 |
| Pneumococcal vaccine adult CPT 90732 • Preventive Care | $20 | $88 | $133 |
| Zoster vaccine recombinant adjuvanted CPT 90750 • Preventive Care | $120 | $180 | $220 |
| Preventive visit new patient infant CPT 99381 • Preventive Care | $88 | $108 | $128 |
| Preventive visit new patient age 1-4 CPT 99382 • Preventive Care | $89 | $105 | $113 |
| Preventive visit new patient age 5-11 CPT 99383 • Preventive Care | $85 | $111 | $139 |
| Preventive visit new patient age 12-17 CPT 99384 • Preventive Care | $10 | $105 | $158 |
| Preventive visit new patient age 18-39 CPT 99385 • Preventive Care | $114 | $129 | $153 |
| Preventive visit new patient age 40-64 CPT 99386 • Preventive Care | $82 | $134 | $177 |
| Preventive visit new patient age 65+ CPT 99387 • Preventive Care | $62 | $112 | $162 |
| Preventive visit established patient infant CPT 99391 • Preventive Care | $97 | $107 | $115 |
| Preventive visit established patient age 1-4 CPT 99392 • Preventive Care | $75 | $101 | $123 |
| Preventive visit established patient age 5-11 CPT 99393 • Preventive Care | $75 | $102 | $122 |
| Preventive visit established patient age 12-17 CPT 99394 • Preventive Care | $97 | $111 | $134 |
| Preventive visit established patient age 18-39 CPT 99395 • Preventive Care | $99 | $114 | $137 |
| Preventive visit established patient age 40-64 CPT 99396 • Preventive Care | $7 | $88 | $147 |
| Preventive visit established patient age 65+ CPT 99397 • Preventive Care | $37 | $103 | $158 |
| Cervical or vaginal cancer screening pelvic exam HCPCS G0101 • Preventive Care | $5 | $22 | $39 |
| Colorectal cancer screening flexible sigmoidoscopy HCPCS G0104 • Preventive Care | $55 | $64 | $73 |
| Colorectal cancer screening colonoscopy high risk HCPCS G0105 • Preventive Care | $139 | $232 | $323 |
| Colorectal cancer screening colonoscopy not high risk HCPCS G0121 • Preventive Care | $139 | $186 | $235 |
| Initial preventive physical exam (Welcome to Medicare) HCPCS G0402 • Preventive Care | $87 | $124 | $160 |
| Annual wellness visit initial HCPCS G0438 • Preventive Care | $130 | $172 | $196 |
| Annual wellness visit subsequent HCPCS G0439 • Preventive Care | $76 | $111 | $153 |
| Bronchoscopy diagnostic CPT 31622 • Pulmonology | $41 | $139 | $236 |
| Bronchoscopy with brushing CPT 31623 • Pulmonology | $41 | $152 | $263 |
| Bronchoscopy with bronchial alveolar lavage CPT 31624 • Pulmonology | $41 | $143 | $245 |
| Bronchoscopy with biopsy CPT 31625 • Pulmonology | $278 | $307 | $336 |
| Bronchoscopy with transbronchial lung biopsy CPT 31628 • Pulmonology | $41 | $179 | $357 |
| Bronchoscopy with endobronchial ultrasound biopsy CPT 31652 • Pulmonology | $97 | $584 | $1,072 |
| Ventilation assist and management initiation CPT 94002 • Pulmonology | $80 | $85 | $90 |
| Spirometry CPT 94010 • Pulmonology | $7 | $18 | $31 |
| Spirometry before and after bronchodilator CPT 94060 • Pulmonology | $32 | $43 | $57 |
| Bronchospasm provocation evaluation CPT 94070 • Pulmonology | $29 | $43 | $57 |
| Respiratory flow volume loop CPT 94375 • Pulmonology | $23 | $29 | $36 |
| Cardiopulmonary exercise test CPT 94621 • Pulmonology | $41 | $55 | $68 |
| Nebulizer inhalation treatment CPT 94640 • Pulmonology | $7 | $12 | $17 |
| Aerosol or vapor inhalation initial demonstration CPT 94664 • Pulmonology | $3 | $12 | $17 |
| Plethysmography lung volumes CPT 94726 • Pulmonology | $25 | $41 | $52 |
| Gas dilution lung volumes CPT 94727 • Pulmonology | $11 | $27 | $42 |