| Code | Description | Price | Price Type | Last Updated |
|---|---|---|---|---|
| 99211 | OP VISIT LEVEL 1 EST | $971 [source] | gross_charge | 1 month ago |
| 99212 | OP VISIT LEVEL 2 EST | $1,189 [source] | gross_charge | 1 month ago |
| 99213 | OP VISIT LEVEL 3 EST | $2,112 [source] | gross_charge | 1 month ago |
| 99214 | OP VISIT LEVEL 4 EST | $2,227 [source] | gross_charge | 1 month ago |
| C1713 | IMPLANT CUSTOM COMPLEXIT | $35,888 [source] | gross_charge | 1 month ago |
| C1725 | CATH ULTSND 7.0MM 60 MM | $12,448 [source] | gross_charge | 1 month ago |
| C1776 | IMPLANT ACTB HIP CUST | $81,000 [source] | gross_charge | 1 month ago |
| C1874 | STENT AOR 37ML 15CM 8MM | $80,000 [source] | gross_charge | 1 month ago |
| C1876 | STENT CLN 22X90MM 270CM | $6,238 [source] | gross_charge | 1 month ago |