| Code | Description | Price | Price Type | Last Updated |
|---|---|---|---|---|
| 29240 | Strap Shoulder LT * | $264 [source] | — | 4 years ago |
| 99211 | VISIT ESTABLISHED LEVEL 1 * | $442 [source] | — | 4 years ago |
| 99212 | VISIT ESTABLISHED LEVEL 2 * | $535 [source] | — | 4 years ago |
| 99213 | VISIT ESTABLISHED LEVEL 3 * | $535 [source] | — | 4 years ago |
| 99214 | VISIT ESTABLISHED LEVEL 4 * | $535 [source] | — | 4 years ago |
| C1821 | Interspinous process distraction device (implantable) * | $27,986 [source] | — | 4 years ago |
| C1874 | Stent, coated/covered, with delivery system * | $54,964 [source] | — | 4 years ago |
| V2632 | Posterior chamber intraocular lens * | $1,386 [source] | — | 4 years ago |
| V2787 | Astigmatism correcting function of intraocular lens * | $608 [source] | — | 4 years ago |