| Code | Description | Price | Price Type | Last Updated |
|---|---|---|---|---|
| 99211 | VISIT ESTABLISHED LEVEL 1 * | $145 [source] | โ | 4 years ago |
| 99212 | VISIT ESTABLISHED LEVEL 2 * | $208 [source] | โ | 4 years ago |
| 99213 | VISIT ESTABLISHED LEVEL 3 * | $273 [source] | โ | 4 years ago |
| 99214 | VISIT ESTABLISHED LEVEL 4 * | $383 [source] | โ | 4 years ago |
| C1874 | Stent, coated/covered, with delivery system * | $24 [source] | โ | 4 years ago |
| C1876 | Stent, non-coated/non-covered, with delivery system * | $2,566 [source] | โ | 4 years ago |