| Code | Description | Price | Price Type | Last Updated |
|---|---|---|---|---|
| 99211 | OP VISIT LEVEL 1 EST | $858 [source] | gross_charge | 2 weeks ago |
| 99212 | OP VISIT LEVEL 2 EST | $858 [source] | gross_charge | 2 weeks ago |
| 99213 | OP VISIT LEVEL 3 EST | $929 [source] | gross_charge | 2 weeks ago |
| 99214 | OP VISIT LEVEL 4 EST | $1,329 [source] | gross_charge | 2 weeks ago |
| C1713 | PLTE AILERN EXPNDL G3 SM | $100,000 [source] | gross_charge | 2 weeks ago |
| C1725 | CATH BLNDIL 2.75MM 30MM | $100,000 [source] | gross_charge | 2 weeks ago |
| C1776 | WEDGE TIB KN CONE SZSM | $100,000 [source] | gross_charge | 2 weeks ago |
| C1821 | SPACER INTERSPINOUS 16MM | $100,000 [source] | gross_charge | 2 weeks ago |
| C1874 | STENT VASC 46MM 80MM | $100,000 [source] | gross_charge | 2 weeks ago |
| C1876 | STENT GRT EVAS 36X100MMM | $100,000 [source] | gross_charge | 2 weeks ago |
| V2632 | LENS IOL +20.0 DIOP | $1,660 [source] | gross_charge | 2 weeks ago |