| Respiratory assist device BiPAP without backup HCPCS E0470 • Sleep Medicine | $914 | $914 | $914 |
| CPAP device continuous positive airway pressure HCPCS E0601 • Sleep Medicine | $374 | $393 | $411 |
| Laparoscopic radical nephrectomy CPT 50545 • Urology | $1,680 | $1,680 | $1,680 |
| Lithotripsy extracorporeal shock wave (ESWL) CPT 50590 • Urology | $30 | $30 | $30 |
| Complex uroflowmetry CPT 51741 • Urology | $5 | $5 | $5 |
| Post-void residual urine measurement CPT 51798 • Urology | $13 | $13 | $13 |
| Cystourethroscopy diagnostic CPT 52000 • Urology | $309 | $309 | $309 |
| Cystourethroscopy with tumor fulguration small CPT 52234 • Urology | $307 | $307 | $307 |
| Cystourethroscopy with tumor fulguration medium CPT 52235 • Urology | $360 | $360 | $360 |
| Cystourethroscopy with dilation of ureteral stricture CPT 52260 • Urology | $21 | $21 | $21 |
| Cystourethroscopy with ureteral stent insertion CPT 52332 • Urology | $299 | $299 | $299 |
| Cystourethroscopy with lithotripsy CPT 52353 • Urology | $490 | $490 | $490 |
| TURP transurethral resection of prostate CPT 52601 • Urology | $917 | $917 | $917 |
| Laser vaporization of prostate CPT 52648 • Urology | $320 | $320 | $320 |
| Circumcision CPT 54150 • Urology | $30 | $94 | $159 |
| Orchiectomy radical inguinal CPT 54530 • Urology | $530 | $530 | $530 |
| Vasectomy CPT 55250 • Urology | $320 | $320 | $320 |
| Radical prostatectomy retropubic CPT 55840 • Urology | $30 | $30 | $30 |
| Laparoscopic radical prostatectomy CPT 55866 • Urology | $30 | $764 | $1,498 |