| Code | Description | Price | Price Type | Last Updated |
|---|---|---|---|---|
| 29240 | Strap Shoulder LT * | $135 [source] | — | 4 years ago |
| 99211 | VISIT ESTABLISHED LEVEL 1 * | $34 [source] | — | 4 years ago |
| 99212 | VISIT ESTABLISHED LEVEL 2 * | $41 [source] | — | 4 years ago |
| 99213 | VISIT ESTABLISHED LEVEL 3 * | $79 [source] | — | 4 years ago |
| 99214 | VISIT ESTABLISHED LEVEL 4 * | $118 [source] | — | 4 years ago |
| C1725 | Catheter, transluminal angioplasty, non-laser (may include guidance, infusion/perfusion capability) * | $41 [source] | — | 4 years ago |
| C1776 | Joint device (implantable) * | $64 [source] | — | 4 years ago |
| C1821 | Interspinous process distraction device (implantable) * | $12,387 [source] | — | 4 years ago |
| C1874 | Stent, coated/covered, with delivery system * | $322 [source] | — | 4 years ago |
| C1876 | Stent, non-coated/non-covered, with delivery system * | $148 [source] | — | 4 years ago |
| V2632 | Posterior chamber intraocular lens * | $107 [source] | — | 4 years ago |
| V2787 | Astigmatism correcting function of intraocular lens * | $346 [source] | — | 4 years ago |