| Code | Description | Price | Price Type | Last Updated |
|---|---|---|---|---|
| 99211 | VISIT ESTABLISHED LEVEL 1 * | $88 [source] | โ | 4 years ago |
| 99212 | VISIT ESTABLISHED LEVEL 2 * | $103 [source] | โ | 4 years ago |
| 99213 | VISIT ESTABLISHED LEVEL 3 * | $128 [source] | โ | 4 years ago |
| 99214 | VISIT ESTABLISHED LEVEL 4 * | $152 [source] | โ | 4 years ago |
| V2787 | Astigmatism correcting function of intraocular lens * | $2,078 [source] | โ | 4 years ago |