| Immunization admin first vaccine component CPT 90460 • Preventive Care | $10 | $26 | $43 |
| Immunization admin each additional component CPT 90461 • Preventive Care | $5 | $13 | $21 |
| Immunization admin injection single CPT 90471 • Preventive Care | $2 | $18 | $34 |
| Immunization admin injection each additional CPT 90472 • Preventive Care | $2 | $9 | $17 |
| HPV vaccine 9-valent CPT 90651 • Preventive Care | $27 | $211 | $395 |
| Pneumococcal conjugate vaccine 13-valent CPT 90670 • Preventive Care | $258 | $265 | $272 |
| Rotavirus vaccine pentavalent CPT 90680 • Preventive Care | $105 | $114 | $123 |
| Influenza vaccine quadrivalent preservative free CPT 90686 • Preventive Care | $12 | $18 | $24 |
| MMR vaccine CPT 90707 • Preventive Care | $23 | $70 | $117 |
| Tdap vaccine age 7 years or older CPT 90715 • Preventive Care | $6 | $33 | $59 |
| Varicella vaccine CPT 90716 • Preventive Care | $98 | $164 | $230 |
| Pneumococcal vaccine adult CPT 90732 • Preventive Care | $13 | $77 | $141 |
| Zoster vaccine recombinant adjuvanted CPT 90750 • Preventive Care | $94 | $188 | $282 |
| Preventive visit new patient infant CPT 99381 • Preventive Care | $74 | $111 | $149 |
| Preventive visit new patient age 1-4 CPT 99382 • Preventive Care | $12 | $60 | $108 |
| Preventive visit new patient age 5-11 CPT 99383 • Preventive Care | $6 | $57 | $108 |
| Preventive visit new patient age 12-17 CPT 99384 • Preventive Care | $99 | $136 | $173 |
| Preventive visit new patient age 18-39 CPT 99385 • Preventive Care | $64 | $93 | $121 |
| Preventive visit new patient age 40-64 CPT 99386 • Preventive Care | $12 | $107 | $203 |
| Preventive visit new patient age 65+ CPT 99387 • Preventive Care | $68 | $144 | $221 |
| Preventive visit established patient infant CPT 99391 • Preventive Care | $10 | $65 | $120 |
| Preventive visit established patient age 1-4 CPT 99392 • Preventive Care | $10 | $52 | $94 |
| Preventive visit established patient age 5-11 CPT 99393 • Preventive Care | $9 | $52 | $94 |
| Preventive visit established patient age 12-17 CPT 99394 • Preventive Care | $83 | $96 | $108 |
| Preventive visit established patient age 18-39 CPT 99395 • Preventive Care | $86 | $97 | $108 |
| Preventive visit established patient age 40-64 CPT 99396 • Preventive Care | $123 | $142 | $161 |
| Preventive visit established patient age 65+ CPT 99397 • Preventive Care | $10 | $73 | $136 |
| Cervical or vaginal cancer screening pelvic exam HCPCS G0101 • Preventive Care | $3 | $30 | $58 |
| Colorectal cancer screening flexible sigmoidoscopy HCPCS G0104 • Preventive Care | $41 | $68 | $94 |
| Colorectal cancer screening colonoscopy high risk HCPCS G0105 • Preventive Care | $34 | $324 | $615 |
| Colorectal cancer screening colonoscopy not high risk HCPCS G0121 • Preventive Care | $51 | $191 | $331 |
| Initial preventive physical exam (Welcome to Medicare) HCPCS G0402 • Preventive Care | $110 | $137 | $163 |
| Annual wellness visit initial HCPCS G0438 • Preventive Care | $163 | $232 | $302 |
| Annual wellness visit subsequent HCPCS G0439 • Preventive Care | $127 | $164 | $202 |
| Bronchoscopy diagnostic CPT 31622 • Pulmonology | $64 | $148 | $231 |
| Bronchoscopy with brushing CPT 31623 • Pulmonology | $27 | $131 | $234 |
| Bronchoscopy with bronchial alveolar lavage CPT 31624 • Pulmonology | $50 | $284 | $517 |
| Bronchoscopy with biopsy CPT 31625 • Pulmonology | $31 | $292 | $552 |
| Bronchoscopy with transbronchial lung biopsy CPT 31628 • Pulmonology | $86 | $374 | $661 |
| Bronchoscopy with endobronchial ultrasound biopsy CPT 31652 • Pulmonology | $1,278 | $1,438 | $1,598 |
| Ventilation assist and management initiation CPT 94002 • Pulmonology | $91 | $116 | $141 |
| Spirometry CPT 94010 • Pulmonology | $13 | $13 | $13 |
| Spirometry before and after bronchodilator CPT 94060 • Pulmonology | $23 | $27 | $30 |
| Bronchospasm provocation evaluation CPT 94070 • Pulmonology | $60 | $78 | $96 |
| Respiratory flow volume loop CPT 94375 • Pulmonology | $23 | $30 | $37 |
| Cardiopulmonary exercise test CPT 94621 • Pulmonology | $68 | $91 | $113 |
| Nebulizer inhalation treatment CPT 94640 • Pulmonology | $22 | $33 | $44 |
| Aerosol or vapor inhalation initial demonstration CPT 94664 • Pulmonology | $24 | $32 | $40 |
| Plethysmography lung volumes CPT 94726 • Pulmonology | $26 | $50 | $75 |
| Gas dilution lung volumes CPT 94727 • Pulmonology | $12 | $45 | $77 |