| Code | Description | Price | Price Type | Last Updated |
|---|---|---|---|---|
| 99211 | REM/ADJ DEV/CATH ONLY EP | $866 [source] | gross_charge | 2 weeks ago |
| 99212 | OP VISIT LEVEL 2 EST | $1,832 [source] | gross_charge | 2 weeks ago |
| 99213 | OP VISIT LEVEL 3 EST | $2,913 [source] | gross_charge | 2 weeks ago |
| 99214 | OP VISIT LEVEL 4 EST | $3,995 [source] | gross_charge | 2 weeks ago |
| C1713 | MESH STRATTICE RECON | $51,486 [source] | gross_charge | 2 weeks ago |
| C1725 | CATH BLN PRPF 80MM 150CM | $22,635 [source] | gross_charge | 2 weeks ago |
| C1776 | STEM HUM 180MM 11MM PVRS | $28,918 [source] | gross_charge | 2 weeks ago |
| C1874 | STENT GRAFT ENDURANT II | $58,120 [source] | gross_charge | 2 weeks ago |
| C1876 | GRAFT EVAS 22FR 30X95MM | $46,351 [source] | gross_charge | 2 weeks ago |
| V2787 | LENS IOL +20.5 DIOP 2.25 | $7,114 [source] | gross_charge | 2 weeks ago |
| C1821 | Interspinous process distraction device (implantable) * | $17,533 [source] | — | 4 years ago |
| V2632 | Posterior chamber intraocular lens * | $569 [source] | — | 4 years ago |