| Code | Description | Price | Price Type | Last Updated |
|---|---|---|---|---|
| 99211 | OP VISIT LEVEL 1 EST | $723 [source] | gross_charge | 1 month ago |
| 99212 | OP VISIT LEVEL 2 EST | $723 [source] | gross_charge | 1 month ago |
| 99213 | OP VISIT LEVEL 3 EST | $817 [source] | gross_charge | 1 month ago |
| 99214 | OP VISIT LEVEL 4 EST | $1,115 [source] | gross_charge | 1 month ago |
| C1713 | IMPLNT CRNL 100-150SQCM | $70,931 [source] | gross_charge | 1 month ago |
| C1725 | CATH AOR 6MM 60MM 130CM | $7,242 [source] | gross_charge | 1 month ago |
| C1776 | CMPNT FEM KN LT SZB | $45,363 [source] | gross_charge | 1 month ago |
| C1821 | IMPLNT SPN 10MM | $26,612 [source] | gross_charge | 1 month ago |
| C1874 | GRAFT STNT 25MM 16X70MM | $56,048 [source] | gross_charge | 1 month ago |
| C1876 | GRFT C 16X 16MM IL STNT | $12,760 [source] | gross_charge | 1 month ago |
| V2632 | LENS IOL SA60AT 16.5 | $894 [source] | gross_charge | 1 month ago |