| Code | Description | Price | Price Type | Last Updated |
|---|---|---|---|---|
| 99211 | OP VISIT LEVEL 1 EST | $764 [source] | gross_charge | 1 month ago |
| 99212 | OP VISIT LEVEL 2 EST | $1,133 [source] | gross_charge | 1 month ago |
| 99213 | OP VISIT LEVEL 3 EST | $1,696 [source] | gross_charge | 1 month ago |
| 99214 | OP VISIT LEVEL 4 EST | $1,886 [source] | gross_charge | 1 month ago |
| C1713 | PLATE BN CNRNFCL LF | $52,734 [source] | gross_charge | 1 month ago |
| C1725 | CATHETER BLN L27MM OD3M | $63,275 [source] | gross_charge | 1 month ago |
| C1776 | CMPNT DOME ANKL SZ3 | $40,219 [source] | gross_charge | 1 month ago |
| C1821 | IMPLNT SPN 8MM | $19,600 [source] | gross_charge | 1 month ago |
| C1874 | STENT GRFT AOR 22FR 31MM | $112,000 [source] | gross_charge | 1 month ago |
| C1876 | STENT DVTR FLW 4.5X40MM | $50,873 [source] | gross_charge | 1 month ago |
| V2632 | LENS IOL +13.0 DIOP | $482 [source] | gross_charge | 1 month ago |