| Code | Description | Price | Price Type | Last Updated |
|---|---|---|---|---|
| 99211 | VISIT ESTABLISHED LEVEL 1 * | $112 [source] | — | 4 years ago |
| 99212 | VISIT ESTABLISHED LEVEL 2 * | $224 [source] | — | 4 years ago |
| 99213 | VISIT ESTABLISHED LEVEL 3 * | $391 [source] | — | 4 years ago |
| 99214 | VISIT ESTABLISHED LEVEL 4 * | $208 [source] | — | 4 years ago |
| C1725 | Catheter, transluminal angioplasty, non-laser (may include guidance, infusion/perfusion capability) * | $107 [source] | — | 4 years ago |
| V2632 | Posterior chamber intraocular lens * | $107 [source] | — | 4 years ago |
| V2787 | Astigmatism correcting function of intraocular lens * | $72 [source] | — | 4 years ago |