| Immunization admin first vaccine component CPT 90460 • Preventive Care | $10 | $11 | $13 |
| Immunization admin each additional component CPT 90461 • Preventive Care | $5 | $7 | $10 |
| Immunization admin injection single CPT 90471 • Preventive Care | $11 | $11 | $12 |
| Immunization admin injection each additional CPT 90472 • Preventive Care | $8 | $9 | $11 |
| HPV vaccine 9-valent CPT 90651 • Preventive Care | $217 | $217 | $217 |
| Pneumococcal conjugate vaccine 13-valent CPT 90670 • Preventive Care | $171 | $200 | $230 |
| Rotavirus vaccine pentavalent CPT 90680 • Preventive Care | $102 | $103 | $104 |
| Influenza vaccine quadrivalent preservative free CPT 90686 • Preventive Care | $20 | $21 | $22 |
| MMR vaccine CPT 90707 • Preventive Care | $64 | $82 | $100 |
| Tdap vaccine age 7 years or older CPT 90715 • Preventive Care | $39 | $44 | $50 |
| Varicella vaccine CPT 90716 • Preventive Care | $192 | $193 | $195 |
| Pneumococcal vaccine adult CPT 90732 • Preventive Care | $117 | $117 | $117 |
| Zoster vaccine recombinant adjuvanted CPT 90750 • Preventive Care | $216 | $216 | $216 |
| Preventive visit new patient infant CPT 99381 • Preventive Care | $64 | $93 | $108 |
| Preventive visit new patient age 1-4 CPT 99382 • Preventive Care | $88 | $101 | $115 |
| Preventive visit new patient age 5-11 CPT 99383 • Preventive Care | $89 | $101 | $113 |
| Preventive visit new patient age 12-17 CPT 99384 • Preventive Care | $47 | $84 | $123 |
| Preventive visit new patient age 18-39 CPT 99385 • Preventive Care | $98 | $110 | $121 |
| Preventive visit new patient age 40-64 CPT 99386 • Preventive Care | $88 | $88 | $88 |
| Preventive visit new patient age 65+ CPT 99387 • Preventive Care | $59 | $91 | $123 |
| Preventive visit established patient infant CPT 99391 • Preventive Care | $56 | $58 | $60 |
| Preventive visit established patient age 1-4 CPT 99392 • Preventive Care | $61 | $64 | $67 |
| Preventive visit established patient age 5-11 CPT 99393 • Preventive Care | $63 | $65 | $67 |
| Preventive visit established patient age 12-17 CPT 99394 • Preventive Care | $67 | $84 | $100 |
| Preventive visit established patient age 18-39 CPT 99395 • Preventive Care | $66 | $85 | $103 |
| Preventive visit established patient age 40-64 CPT 99396 • Preventive Care | $73 | $83 | $94 |
| Preventive visit established patient age 65+ CPT 99397 • Preventive Care | $76 | $96 | $109 |
| Cervical or vaginal cancer screening pelvic exam HCPCS G0101 • Preventive Care | $23 | $34 | $44 |
| Colorectal cancer screening flexible sigmoidoscopy HCPCS G0104 • Preventive Care | $30 | $67 | $104 |
| Colorectal cancer screening colonoscopy high risk HCPCS G0105 • Preventive Care | $60 | $186 | $263 |
| Colorectal cancer screening colonoscopy not high risk HCPCS G0121 • Preventive Care | $264 | $264 | $264 |
| Initial preventive physical exam (Welcome to Medicare) HCPCS G0402 • Preventive Care | $98 | $100 | $100 |
| Annual wellness visit initial HCPCS G0438 • Preventive Care | $103 | $117 | $130 |
| Annual wellness visit subsequent HCPCS G0439 • Preventive Care | $70 | $74 | $78 |
| Bronchoscopy diagnostic CPT 31622 • Pulmonology | $104 | $247 | $318 |
| Bronchoscopy with brushing CPT 31623 • Pulmonology | $103 | $224 | $345 |
| Bronchoscopy with bronchial alveolar lavage CPT 31624 • Pulmonology | $153 | $176 | $198 |
| Bronchoscopy with biopsy CPT 31625 • Pulmonology | $122 | $267 | $413 |
| Bronchoscopy with transbronchial lung biopsy CPT 31628 • Pulmonology | $42 | $138 | $234 |
| Bronchoscopy with endobronchial ultrasound biopsy CPT 31652 • Pulmonology | $880 | $914 | $947 |
| Ventilation assist and management initiation CPT 94002 • Pulmonology | $48 | $64 | $80 |
| Spirometry CPT 94010 • Pulmonology | $17 | $27 | $32 |
| Spirometry before and after bronchodilator CPT 94060 • Pulmonology | $54 | $60 | $66 |
| Bronchospasm provocation evaluation CPT 94070 • Pulmonology | $52 | $58 | $64 |
| Respiratory flow volume loop CPT 94375 • Pulmonology | $16 | $29 | $42 |
| Cardiopulmonary exercise test CPT 94621 • Pulmonology | $100 | $122 | $143 |
| Nebulizer inhalation treatment CPT 94640 • Pulmonology | $20 | $20 | $20 |
| Aerosol or vapor inhalation initial demonstration CPT 94664 • Pulmonology | $12 | $12 | $12 |
| Plethysmography lung volumes CPT 94726 • Pulmonology | $13 | $35 | $47 |
| Gas dilution lung volumes CPT 94727 • Pulmonology | $10 | $14 | $22 |