| Code | Description | Price | Price Type | Last Updated |
|---|---|---|---|---|
| 99211 | OP VISIT LEVEL 1 EST | $186 [source] | gross_charge | 1 month ago |
| 99212 | OP VISIT LEVEL 2 EST | $278 [source] | gross_charge | 1 month ago |
| 99213 | OP VISIT LEVEL 3 EST | $340 [source] | gross_charge | 1 month ago |
| 99214 | OP VISIT LEVEL 4 EST | $433 [source] | gross_charge | 1 month ago |
| C1713 | PLATE BN HMSPHR 28H 2.8 | $116,640 [source] | gross_charge | 1 month ago |
| C1725 | CATH ULTSND IVL 5.5X60MM | $71,943 [source] | gross_charge | 1 month ago |
| C1776 | COMPNT STEM ROT KN MED | $108,000 [source] | gross_charge | 1 month ago |
| C1874 | GRAFT EVAS 137MM 36MM | $116,640 [source] | gross_charge | 1 month ago |
| C1876 | STENT THOR AOR 15CM 31MM | $108,000 [source] | gross_charge | 1 month ago |
| V2632 | LENS IOL +15.5 DIOP | $2,707 [source] | gross_charge | 1 month ago |
| V2787 | LENS IOL +23.5 DIOP | $7,656 [source] | gross_charge | 1 month ago |