Payer
Medicare preventive services
These procedures are flagged by Medicare as preventive services typically covered at no cost-sharing under Part B when ordered for a qualifying indication. Always confirm with your plan — coverage can vary by code modifier and reason for the visit.
Procedures
13
in this collection
With data on file
13
0 pending hospital coverage
Hospital-procedure pairs
423
reported across CO
CMS shoppable
3 of 13
on the federal mandate list
Procedures in this collection
Shingrix (Shingles Vaccine)
Two-dose recombinant zoster vaccine to prevent shingles. The CDC recommends Shingrix for adults 50 and older, including those previously vaccinated with Zostavax.
CPT 90750·VaccinesMedicare preventive
$328 – $649
16 hospitals · 25th–75th
Pneumovax 23 (PPSV23 Pneumococcal)
23-valent pneumococcal polysaccharide vaccine recommended for adults 65 and older, and earlier for those with chronic conditions.
CPT 90732·VaccinesMedicare preventive
$199 – $395
35 hospitals · 25th–75th
Prevnar 20 (PCV20 Pneumococcal Conjugate)
20-valent pneumococcal conjugate vaccine, the broader-coverage option for adults 65+ alongside or instead of PPSV23.
CPT 90671·VaccinesMedicare preventive
$256 – $428
27 hospitals · 25th–75th
Influenza Vaccine, Quadrivalent (Flu Shot)
Annual quadrivalent flu vaccine for adults. CDC recommends for everyone 6 months and older, with high-dose variants for adults 65+.
CPT 90686·VaccinesMedicare preventive
$38 – $83
34 hospitals · 25th–75th
RSV Vaccine (Abrysvo / Arexvy)
Respiratory syncytial virus vaccine, recommended as a one-time dose for adults 60 and older to reduce risk of severe lower-respiratory illness.
CPT 90679·VaccinesMedicare preventive
$386 – $498
2 hospitals · 25th–75th
Screening Mammography (Bilateral)
Annual or biennial screening mammogram for breast cancer detection. Recommended for women starting at 40-50 depending on guideline body, continuing through age 74.
CPT 77067·Cancer ScreeningCMS shoppableMedicare preventive
$137 – $267
37 hospitals · 25th–75th
Low-Dose CT for Lung Cancer Screening
Low-dose chest CT for adults 50-80 with significant smoking history. Annual screening reduces lung cancer mortality and is covered with no cost-sharing under Medicare and most insurers.
CPT 71271·Cancer ScreeningMedicare preventive
$224 – $598
39 hospitals · 25th–75th
Colonoscopy, Diagnostic
Diagnostic colonoscopy to examine the colon for polyps, bleeding, or other findings. Often follows an abnormal stool test or symptoms.
CPT 45378·Cancer ScreeningCMS shoppableMedicare preventive
$247 – $2,099
40 hospitals · 25th–75th
PSA (Prostate-Specific Antigen) Test
Blood test measuring prostate-specific antigen, used as an early indicator for prostate cancer in men 50+ (or earlier with risk factors).
CPT 84153·Cancer ScreeningCMS shoppableMedicare preventive
$32 – $74
37 hospitals · 25th–75th
Flexible Sigmoidoscopy
Examination of the lower colon (sigmoid) — a less-extensive alternative to full colonoscopy, sometimes paired with stool testing.
CPT 45330·Cancer ScreeningMedicare preventive
$96 – $1,592
40 hospitals · 25th–75th
Lipid Panel
Measures total cholesterol, HDL, LDL, and triglycerides. Cornerstone of cardiovascular-risk screening.
CPT 80061·LabMedicare preventive
$21 – $76
39 hospitals · 25th–75th
Hemoglobin A1c (HbA1c)
Three-month average of blood glucose. Used to diagnose diabetes/prediabetes and monitor diabetes control.
CPT 83036·LabMedicare preventive
$16 – $51
38 hospitals · 25th–75th
DEXA Scan (Bone Density)
Dual-energy X-ray absorptiometry to measure bone mineral density. Recommended for women 65+ and men 70+ to screen for osteoporosis.
CPT 77080·ImagingMedicare preventive
$116 – $435
39 hospitals · 25th–75th