| Immunization admin first vaccine component CPT 90460 • Preventive Care | $10 | $14 | $22 |
| Immunization admin each additional component CPT 90461 • Preventive Care | $5 | $8 | $13 |
| Immunization admin injection single CPT 90471 • Preventive Care | $5 | $13 | $19 |
| Immunization admin injection each additional CPT 90472 • Preventive Care | $2 | $9 | $13 |
| HPV vaccine 9-valent CPT 90651 • Preventive Care | $55 | $232 | $371 |
| Pneumococcal conjugate vaccine 13-valent CPT 90670 • Preventive Care | $257 | $269 | $292 |
| Rotavirus vaccine pentavalent CPT 90680 • Preventive Care | $62 | $83 | $97 |
| Influenza vaccine quadrivalent preservative free CPT 90686 • Preventive Care | $3 | $17 | $25 |
| MMR vaccine CPT 90707 • Preventive Care | $9 | $73 | $97 |
| Tdap vaccine age 7 years or older CPT 90715 • Preventive Care | $6 | $33 | $56 |
| Varicella vaccine CPT 90716 • Preventive Care | $33 | $142 | $217 |
| Pneumococcal vaccine adult CPT 90732 • Preventive Care | $20 | $105 | $133 |
| Zoster vaccine recombinant adjuvanted CPT 90750 • Preventive Care | $187 | $206 | $244 |
| Preventive visit new patient infant CPT 99381 • Preventive Care | $16 | $78 | $106 |
| Preventive visit new patient age 1-4 CPT 99382 • Preventive Care | $12 | $75 | $111 |
| Preventive visit new patient age 5-11 CPT 99383 • Preventive Care | $17 | $66 | $115 |
| Preventive visit new patient age 12-17 CPT 99384 • Preventive Care | $13 | $88 | $128 |
| Preventive visit new patient age 18-39 CPT 99385 • Preventive Care | $10 | $92 | $135 |
| Preventive visit new patient age 40-64 CPT 99386 • Preventive Care | $15 | $117 | $156 |
| Preventive visit new patient age 65+ CPT 99387 • Preventive Care | $16 | $133 | $206 |
| Preventive visit established patient infant CPT 99391 • Preventive Care | $34 | $77 | $115 |
| Preventive visit established patient age 1-4 CPT 99392 • Preventive Care | $10 | $94 | $169 |
| Preventive visit established patient age 5-11 CPT 99393 • Preventive Care | $61 | $110 | $171 |
| Preventive visit established patient age 12-17 CPT 99394 • Preventive Care | $42 | $86 | $111 |
| Preventive visit established patient age 18-39 CPT 99395 • Preventive Care | $86 | $104 | $122 |
| Preventive visit established patient age 40-64 CPT 99396 • Preventive Care | $100 | $115 | $123 |
| Preventive visit established patient age 65+ CPT 99397 • Preventive Care | $15 | $122 | $217 |
| Cervical or vaginal cancer screening pelvic exam HCPCS G0101 • Preventive Care | $4 | $24 | $38 |
| Colorectal cancer screening flexible sigmoidoscopy HCPCS G0104 • Preventive Care | $5 | $93 | $183 |
| Colorectal cancer screening colonoscopy high risk HCPCS G0105 • Preventive Care | $36 | $286 | $536 |
| Colorectal cancer screening colonoscopy not high risk HCPCS G0121 • Preventive Care | $90 | $239 | $338 |
| Initial preventive physical exam (Welcome to Medicare) HCPCS G0402 • Preventive Care | $118 | $137 | $163 |
| Annual wellness visit initial HCPCS G0438 • Preventive Care | $163 | $200 | $273 |
| Annual wellness visit subsequent HCPCS G0439 • Preventive Care | $107 | $121 | $127 |
| Bronchoscopy diagnostic CPT 31622 • Pulmonology | $30 | $174 | $248 |
| Bronchoscopy with brushing CPT 31623 • Pulmonology | $27 | $90 | $214 |
| Bronchoscopy with bronchial alveolar lavage CPT 31624 • Pulmonology | $50 | $143 | $236 |
| Bronchoscopy with biopsy CPT 31625 • Pulmonology | $23 | $135 | $353 |
| Bronchoscopy with transbronchial lung biopsy CPT 31628 • Pulmonology | $56 | $96 | $137 |
| Bronchoscopy with endobronchial ultrasound biopsy CPT 31652 • Pulmonology | $192 | $772 | $1,278 |
| Ventilation assist and management initiation CPT 94002 • Pulmonology | $91 | $110 | $147 |
| Spirometry CPT 94010 • Pulmonology | $14 | $26 | $33 |
| Spirometry before and after bronchodilator CPT 94060 • Pulmonology | $7 | $24 | $41 |
| Bronchospasm provocation evaluation CPT 94070 • Pulmonology | $12 | $55 | $94 |
| Respiratory flow volume loop CPT 94375 • Pulmonology | $14 | $38 | $62 |
| Cardiopulmonary exercise test CPT 94621 • Pulmonology | $30 | $144 | $252 |
| Nebulizer inhalation treatment CPT 94640 • Pulmonology | $28 | $29 | $30 |
| Aerosol or vapor inhalation initial demonstration CPT 94664 • Pulmonology | $16 | $22 | $30 |
| Plethysmography lung volumes CPT 94726 • Pulmonology | $12 | $34 | $52 |
| Gas dilution lung volumes CPT 94727 • Pulmonology | $12 | $27 | $42 |