| Code | Description | Price | Price Type | Last Updated |
|---|---|---|---|---|
| 29240 | Strap Shoulder LT * | $48 [source] | — | 4 years ago |
| 99211 | VISIT ESTABLISHED LEVEL 1 * | $115 [source] | — | 4 years ago |
| 99212 | VISIT ESTABLISHED LEVEL 2 * | $63 [source] | — | 4 years ago |
| 99213 | VISIT ESTABLISHED LEVEL 3 * | $68 [source] | — | 4 years ago |
| 99214 | VISIT ESTABLISHED LEVEL 4 * | $73 [source] | — | 4 years ago |
| C1713 | Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) * | $1,275 [source] | — | 4 years ago |
| C1776 | Joint device (implantable) * | $8,100 [source] | — | 4 years ago |
| V2632 | Posterior chamber intraocular lens * | $576 [source] | — | 4 years ago |
| V2787 | Astigmatism correcting function of intraocular lens * | $800 [source] | — | 4 years ago |