| Code | Description | Price | Price Type | Last Updated |
|---|---|---|---|---|
| 99211 | OP VISIT LEVEL 1 EST | $284 [source] | gross_charge | 2 weeks ago |
| 99212 | OP VISIT LEVEL 2 EST | $360 [source] | gross_charge | 2 weeks ago |
| 99213 | OP VISIT LEVEL 3 EST | $410 [source] | gross_charge | 2 weeks ago |
| 99214 | OP VISIT LEVEL 4 EST | $512 [source] | gross_charge | 2 weeks ago |
| C1713 | PLATE BN MIDFC TI 3D | $108,000 [source] | gross_charge | 2 weeks ago |
| C1776 | BLOCK AUG KN RT 69MM | $108,000 [source] | gross_charge | 2 weeks ago |
| V2632 | LENS IOL 20.0 DIOP | $3,450 [source] | gross_charge | 2 weeks ago |
| V2787 | LENS IOL +22.5 DIOP | $3,625 [source] | gross_charge | 2 weeks ago |