| Code | Description | Price | Price Type | Last Updated |
|---|---|---|---|---|
| 99211 | HC ESTAB PT VISIT - LEVEL 1 | $72 [source] | gross_charge | 2 weeks ago |
| 99212 | HC ESTAB PT VISIT - LEVEL 2 | $89 [source] | gross_charge | 2 weeks ago |
| 99213 | HC ESTAB PT VISIT - LEVEL 3 | $89 [source] | gross_charge | 2 weeks ago |
| 99214 | HC ESTAB PT VISIT - LEVEL 4 | $123 [source] | gross_charge | 2 weeks ago |