| Immunization admin first vaccine component CPT 90460 • Preventive Care | $10 | $26 | $58 |
| Immunization admin each additional component CPT 90461 • Preventive Care | $5 | $12 | $27 |
| Immunization admin injection single CPT 90471 • Preventive Care | $1 | $27 | $52 |
| Immunization admin injection each additional CPT 90472 • Preventive Care | $2 | $16 | $38 |
| HPV vaccine 9-valent CPT 90651 • Preventive Care | $168 | $297 | $369 |
| Pneumococcal conjugate vaccine 13-valent CPT 90670 • Preventive Care | $230 | $246 | $279 |
| Rotavirus vaccine pentavalent CPT 90680 • Preventive Care | $10 | $75 | $110 |
| Influenza vaccine quadrivalent preservative free CPT 90686 • Preventive Care | $2 | $15 | $24 |
| MMR vaccine CPT 90707 • Preventive Care | $100 | $103 | $104 |
| Tdap vaccine age 7 years or older CPT 90715 • Preventive Care | $4 | $32 | $54 |
| Varicella vaccine CPT 90716 • Preventive Care | $29 | $144 | $207 |
| Pneumococcal vaccine adult CPT 90732 • Preventive Care | $13 | $91 | $133 |
| Zoster vaccine recombinant adjuvanted CPT 90750 • Preventive Care | $36 | $170 | $242 |
| Preventive visit new patient infant CPT 99381 • Preventive Care | $39 | $122 | $210 |
| Preventive visit new patient age 1-4 CPT 99382 • Preventive Care | $13 | $96 | $153 |
| Preventive visit new patient age 5-11 CPT 99383 • Preventive Care | $13 | $123 | $228 |
| Preventive visit new patient age 12-17 CPT 99384 • Preventive Care | $22 | $106 | $191 |
| Preventive visit new patient age 18-39 CPT 99385 • Preventive Care | $51 | $137 | $183 |
| Preventive visit new patient age 40-64 CPT 99386 • Preventive Care | $18 | $169 | $288 |
| Preventive visit new patient age 65+ CPT 99387 • Preventive Care | $174 | $220 | $313 |
| Preventive visit established patient infant CPT 99391 • Preventive Care | $72 | $130 | $189 |
| Preventive visit established patient age 1-4 CPT 99392 • Preventive Care | $8 | $107 | $202 |
| Preventive visit established patient age 5-11 CPT 99393 • Preventive Care | $39 | $92 | $144 |
| Preventive visit established patient age 12-17 CPT 99394 • Preventive Care | $61 | $112 | $162 |
| Preventive visit established patient age 18-39 CPT 99395 • Preventive Care | $63 | $129 | $168 |
| Preventive visit established patient age 40-64 CPT 99396 • Preventive Care | $20 | $125 | $182 |
| Preventive visit established patient age 65+ CPT 99397 • Preventive Care | $14 | $136 | $258 |
| Cervical or vaginal cancer screening pelvic exam HCPCS G0101 • Preventive Care | $5 | $37 | $72 |
| Colorectal cancer screening flexible sigmoidoscopy HCPCS G0104 • Preventive Care | $9 | $245 | $480 |
| Colorectal cancer screening colonoscopy high risk HCPCS G0105 • Preventive Care | $72 | $478 | $883 |
| Colorectal cancer screening colonoscopy not high risk HCPCS G0121 • Preventive Care | $54 | $432 | $884 |
| Initial preventive physical exam (Welcome to Medicare) HCPCS G0402 • Preventive Care | $115 | $197 | $321 |
| Annual wellness visit initial HCPCS G0438 • Preventive Care | $159 | $213 | $320 |
| Annual wellness visit subsequent HCPCS G0439 • Preventive Care | $108 | $156 | $250 |
| Bronchoscopy diagnostic CPT 31622 • Pulmonology | $111 | $234 | $340 |
| Bronchoscopy with brushing CPT 31623 • Pulmonology | $84 | $354 | $711 |
| Bronchoscopy with bronchial alveolar lavage CPT 31624 • Pulmonology | $23 | $285 | $661 |
| Bronchoscopy with biopsy CPT 31625 • Pulmonology | $65 | $412 | $903 |
| Bronchoscopy with transbronchial lung biopsy CPT 31628 • Pulmonology | $45 | $505 | $965 |
| Bronchoscopy with endobronchial ultrasound biopsy CPT 31652 • Pulmonology | $75 | $464 | $747 |
| Ventilation assist and management initiation CPT 94002 • Pulmonology | $86 | $138 | $241 |
| Spirometry CPT 94010 • Pulmonology | $37 | $41 | $48 |
| Spirometry before and after bronchodilator CPT 94060 • Pulmonology | $50 | $62 | $72 |
| Bronchospasm provocation evaluation CPT 94070 • Pulmonology | $30 | $54 | $73 |
| Respiratory flow volume loop CPT 94375 • Pulmonology | $26 | $32 | $38 |
| Cardiopulmonary exercise test CPT 94621 • Pulmonology | $83 | $155 | $218 |
| Nebulizer inhalation treatment CPT 94640 • Pulmonology | $4 | $20 | $32 |
| Aerosol or vapor inhalation initial demonstration CPT 94664 • Pulmonology | $18 | $31 | $43 |
| Plethysmography lung volumes CPT 94726 • Pulmonology | $54 | $82 | $139 |
| Gas dilution lung volumes CPT 94727 • Pulmonology | $31 | $52 | $81 |