| Immunization admin first vaccine component CPT 90460 • Preventive Care | $10 | $18 | $34 |
| Immunization admin each additional component CPT 90461 • Preventive Care | $5 | $16 | $31 |
| Immunization admin injection single CPT 90471 • Preventive Care | $2 | $26 | $40 |
| Immunization admin injection each additional CPT 90472 • Preventive Care | $1 | $21 | $31 |
| HPV vaccine 9-valent CPT 90651 • Preventive Care | $329 | $332 | $336 |
| Pneumococcal conjugate vaccine 13-valent CPT 90670 • Preventive Care | $258 | $388 | $648 |
| Rotavirus vaccine pentavalent CPT 90680 • Preventive Care | $10 | $68 | $102 |
| Influenza vaccine quadrivalent preservative free CPT 90686 • Preventive Care | $10 | $29 | $54 |
| MMR vaccine CPT 90707 • Preventive Care | $21 | $74 | $109 |
| Tdap vaccine age 7 years or older CPT 90715 • Preventive Care | $38 | $63 | $96 |
| Varicella vaccine CPT 90716 • Preventive Care | $29 | $136 | $215 |
| Pneumococcal vaccine adult CPT 90732 • Preventive Care | $132 | $200 | $335 |
| Zoster vaccine recombinant adjuvanted CPT 90750 • Preventive Care | $239 | $241 | $244 |
| Preventive visit new patient infant CPT 99381 • Preventive Care | $9 | $116 | $249 |
| Preventive visit new patient age 1-4 CPT 99382 • Preventive Care | $79 | $172 | $260 |
| Preventive visit new patient age 5-11 CPT 99383 • Preventive Care | $98 | $161 | $270 |
| Preventive visit new patient age 12-17 CPT 99384 • Preventive Care | $50 | $165 | $308 |
| Preventive visit new patient age 18-39 CPT 99385 • Preventive Care | $10 | $162 | $298 |
| Preventive visit new patient age 40-64 CPT 99386 • Preventive Care | $22 | $95 | $149 |
| Preventive visit new patient age 65+ CPT 99387 • Preventive Care | $22 | $250 | $373 |
| Preventive visit established patient infant CPT 99391 • Preventive Care | $49 | $101 | $153 |
| Preventive visit established patient age 1-4 CPT 99392 • Preventive Care | $7 | $70 | $102 |
| Preventive visit established patient age 5-11 CPT 99393 • Preventive Care | $99 | $100 | $102 |
| Preventive visit established patient age 12-17 CPT 99394 • Preventive Care | $11 | $46 | $82 |
| Preventive visit established patient age 18-39 CPT 99395 • Preventive Care | $11 | $54 | $97 |
| Preventive visit established patient age 40-64 CPT 99396 • Preventive Care | $12 | $130 | $287 |
| Preventive visit established patient age 65+ CPT 99397 • Preventive Care | $20 | $116 | $232 |
| Cervical or vaginal cancer screening pelvic exam HCPCS G0101 • Preventive Care | $5 | $32 | $59 |
| Colorectal cancer screening flexible sigmoidoscopy HCPCS G0104 • Preventive Care | $9 | $127 | $244 |
| Colorectal cancer screening colonoscopy high risk HCPCS G0105 • Preventive Care | $18 | $130 | $282 |
| Colorectal cancer screening colonoscopy not high risk HCPCS G0121 • Preventive Care | $158 | $316 | $524 |
| Initial preventive physical exam (Welcome to Medicare) HCPCS G0402 • Preventive Care | $131 | $174 | $253 |
| Annual wellness visit initial HCPCS G0438 • Preventive Care | $136 | $152 | $163 |
| Annual wellness visit subsequent HCPCS G0439 • Preventive Care | $127 | $137 | $157 |
| Bronchoscopy diagnostic CPT 31622 • Pulmonology | $25 | $286 | $606 |
| Bronchoscopy with brushing CPT 31623 • Pulmonology | $93 | $338 | $680 |
| Bronchoscopy with bronchial alveolar lavage CPT 31624 • Pulmonology | $125 | $248 | $370 |
| Bronchoscopy with biopsy CPT 31625 • Pulmonology | $72 | $416 | $868 |
| Bronchoscopy with transbronchial lung biopsy CPT 31628 • Pulmonology | $19 | $119 | $172 |
| Bronchoscopy with endobronchial ultrasound biopsy CPT 31652 • Pulmonology | $22 | $1,412 | $3,182 |
| Ventilation assist and management initiation CPT 94002 • Pulmonology | $91 | $111 | $150 |
| Spirometry CPT 94010 • Pulmonology | $9 | $17 | $27 |
| Spirometry before and after bronchodilator CPT 94060 • Pulmonology | $9 | $19 | $37 |
| Bronchospasm provocation evaluation CPT 94070 • Pulmonology | $59 | $63 | $70 |
| Respiratory flow volume loop CPT 94375 • Pulmonology | $23 | $29 | $35 |
| Cardiopulmonary exercise test CPT 94621 • Pulmonology | $76 | $100 | $150 |
| Nebulizer inhalation treatment CPT 94640 • Pulmonology | $10 | $15 | $20 |
| Aerosol or vapor inhalation initial demonstration CPT 94664 • Pulmonology | $3 | $11 | $16 |
| Plethysmography lung volumes CPT 94726 • Pulmonology | $13 | $63 | $124 |
| Gas dilution lung volumes CPT 94727 • Pulmonology | $35 | $40 | $44 |