| Immunization admin first vaccine component CPT 90460 • Preventive Care | $12 | $14 | $19 |
| Immunization admin each additional component CPT 90461 • Preventive Care | $7 | $8 | $9 |
| Immunization admin injection single CPT 90471 • Preventive Care | $12 | $16 | $21 |
| Immunization admin injection each additional CPT 90472 • Preventive Care | $7 | $8 | $10 |
| HPV vaccine 9-valent CPT 90651 • Preventive Care | $335 | $365 | $395 |
| Pneumococcal conjugate vaccine 13-valent CPT 90670 • Preventive Care | $230 | $251 | $272 |
| Rotavirus vaccine pentavalent CPT 90680 • Preventive Care | $104 | $114 | $123 |
| Influenza vaccine quadrivalent preservative free CPT 90686 • Preventive Care | $20 | $22 | $24 |
| MMR vaccine CPT 90707 • Preventive Care | $117 | $117 | $117 |
| Tdap vaccine age 7 years or older CPT 90715 • Preventive Care | $39 | $49 | $59 |
| Varicella vaccine CPT 90716 • Preventive Care | $230 | $230 | $230 |
| Pneumococcal vaccine adult CPT 90732 • Preventive Care | $133 | $137 | $141 |
| Zoster vaccine recombinant adjuvanted CPT 90750 • Preventive Care | $219 | $250 | $282 |
| Preventive visit new patient infant CPT 99381 • Preventive Care | $12 | $63 | $112 |
| Preventive visit new patient age 1-4 CPT 99382 • Preventive Care | $48 | $83 | $117 |
| Preventive visit new patient age 5-11 CPT 99383 • Preventive Care | $72 | $96 | $121 |
| Preventive visit new patient age 12-17 CPT 99384 • Preventive Care | $54 | $96 | $137 |
| Preventive visit new patient age 18-39 CPT 99385 • Preventive Care | $78 | $105 | $133 |
| Preventive visit new patient age 40-64 CPT 99386 • Preventive Care | $66 | $110 | $154 |
| Preventive visit new patient age 65+ CPT 99387 • Preventive Care | $73 | $120 | $167 |
| Preventive visit established patient infant CPT 99391 • Preventive Care | $36 | $36 | $36 |
| Preventive visit established patient age 1-4 CPT 99392 • Preventive Care | $62 | $84 | $107 |
| Preventive visit established patient age 5-11 CPT 99393 • Preventive Care | $42 | $75 | $107 |
| Preventive visit established patient age 12-17 CPT 99394 • Preventive Care | $48 | $83 | $117 |
| Preventive visit established patient age 18-39 CPT 99395 • Preventive Care | $48 | $69 | $90 |
| Preventive visit established patient age 40-64 CPT 99396 • Preventive Care | $74 | $100 | $127 |
| Preventive visit established patient age 65+ CPT 99397 • Preventive Care | $61 | $99 | $138 |
| Cervical or vaginal cancer screening pelvic exam HCPCS G0101 • Preventive Care | $26 | $32 | $38 |
| Colorectal cancer screening flexible sigmoidoscopy HCPCS G0104 • Preventive Care | $109 | $109 | $109 |
| Colorectal cancer screening colonoscopy high risk HCPCS G0105 • Preventive Care | $318 | $326 | $333 |
| Colorectal cancer screening colonoscopy not high risk HCPCS G0121 • Preventive Care | $318 | $318 | $318 |
| Initial preventive physical exam (Welcome to Medicare) HCPCS G0402 • Preventive Care | $68 | $132 | $164 |
| Annual wellness visit initial HCPCS G0438 • Preventive Care | $125 | $144 | $163 |
| Annual wellness visit subsequent HCPCS G0439 • Preventive Care | $84 | $106 | $127 |
| Bronchoscopy diagnostic CPT 31622 • Pulmonology | $115 | $244 | $309 |
| Bronchoscopy with brushing CPT 31623 • Pulmonology | $282 | $311 | $340 |
| Bronchoscopy with bronchial alveolar lavage CPT 31624 • Pulmonology | $261 | $261 | $261 |
| Bronchoscopy with biopsy CPT 31625 • Pulmonology | $136 | $284 | $432 |
| Bronchoscopy with transbronchial lung biopsy CPT 31628 • Pulmonology | $337 | $337 | $337 |
| Bronchoscopy with endobronchial ultrasound biopsy CPT 31652 • Pulmonology | $823 | $1,179 | $1,534 |
| Ventilation assist and management initiation CPT 94002 • Pulmonology | $61 | $85 | $108 |
| Spirometry CPT 94010 • Pulmonology | $6 | $15 | $30 |
| Spirometry before and after bronchodilator CPT 94060 • Pulmonology | $31 | $38 | $44 |
| Bronchospasm provocation evaluation CPT 94070 • Pulmonology | $45 | $57 | $69 |
| Respiratory flow volume loop CPT 94375 • Pulmonology | $28 | $28 | $28 |
| Cardiopulmonary exercise test CPT 94621 • Pulmonology | $121 | $147 | $174 |
| Nebulizer inhalation treatment CPT 94640 • Pulmonology | $10 | $10 | $10 |
| Aerosol or vapor inhalation initial demonstration CPT 94664 • Pulmonology | $12 | $12 | $12 |
| Plethysmography lung volumes CPT 94726 • Pulmonology | $9 | $39 | $61 |
| Gas dilution lung volumes CPT 94727 • Pulmonology | $9 | $36 | $49 |