| Code | Description | Price | Price Type | Last Updated |
|---|---|---|---|---|
| 99211 | OP VISIT LEVEL 1 EST | $659 [source] | gross_charge | 1 month ago |
| 99212 | OP VISIT LEVEL 2 EST | $1,525 [source] | gross_charge | 1 month ago |
| 99213 | OP VISIT LEVEL 3 EST | $1,971 [source] | gross_charge | 1 month ago |
| 99214 | OP VISIT LEVEL 4 EST | $2,631 [source] | gross_charge | 1 month ago |
| C1713 | IMPL SAC JNT FUSN SYMTR | $29,060 [source] | gross_charge | 1 month ago |
| C1725 | CATH BLN 137CM 6X200MM | $4,631 [source] | gross_charge | 1 month ago |
| C1776 | STEM HUM SHLDR REV SM | $28,433 [source] | gross_charge | 1 month ago |
| C1821 | IMPLNT SPN 12MM | $21,230 [source] | gross_charge | 1 month ago |
| C1874 | GRAFT ZEN MAIN TFB26117 | $28,053 [source] | gross_charge | 1 month ago |
| C1876 | STENT NEUROFORM3 4.5X15 | $20,851 [source] | gross_charge | 1 month ago |
| V2632 | LENS ACRSF .28 L13XOD6 | $615 [source] | gross_charge | 1 month ago |