| Code | Description | Price | Price Type | Last Updated |
|---|---|---|---|---|
| 99211 | OP VISIT LEVEL 1 EST | $383 [source] | gross_charge | 2 weeks ago |
| 99212 | OP VISIT LEVEL 2 EST | $498 [source] | gross_charge | 2 weeks ago |
| 99213 | OP VISIT LEVEL 3 EST | $625 [source] | gross_charge | 2 weeks ago |
| 99214 | OP VISIT LEVEL 4 EST | $1,188 [source] | gross_charge | 2 weeks ago |
| C1713 | IMPLANT CRNL XL PEK CSTM | $100,000 [source] | gross_charge | 2 weeks ago |
| C1725 | CATH ULTSND IVL 6.5X60MM | $34,238 [source] | gross_charge | 2 weeks ago |
| C1776 | STEM FEM STD 240MM SZ17 | $74,019 [source] | gross_charge | 2 weeks ago |
| C1821 | IMPLNT SPN 10MM | $51,217 [source] | gross_charge | 2 weeks ago |
| C1874 | STENT THOR AOR 40MM 10CM | $100,000 [source] | gross_charge | 2 weeks ago |
| C1876 | STENT VASC 450MM 20MM | $100,000 [source] | gross_charge | 2 weeks ago |
| V2632 | LENS IOL +22.0 DIOP | $10,832 [source] | gross_charge | 2 weeks ago |
| V2787 | LENS IOL 0 D +19 DIOP +1 | $10,832 [source] | gross_charge | 2 weeks ago |