| Code | Description | Price | Price Type | Last Updated |
|---|---|---|---|---|
| 99211 | OP VISIT LEVEL 1 EST | $436 [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 | $607 [source] | gross_charge | 2 weeks ago |
| 99214 | OP VISIT LEVEL 4 EST | $759 [source] | gross_charge | 2 weeks ago |
| C1713 | PLATE MESH 175X20X80MM | $100,000 [source] | gross_charge | 2 weeks ago |
| C1725 | CATH ULTSND IVL 4.5X60MM | $79,585 [source] | gross_charge | 2 weeks ago |
| C1776 | TRAY TIB CADNC 3 FT LT T | $100,000 [source] | gross_charge | 2 weeks ago |
| C1874 | GRAFT STNT 28MM 117MM | $100,000 [source] | gross_charge | 2 weeks ago |
| C1876 | COIL EMBL 3.5MM 24MM | $100,000 [source] | gross_charge | 2 weeks ago |