| Code | Description | Price | Price Type | Last Updated |
|---|---|---|---|---|
| 99211 | OP VISIT LEVEL 1 EST | $603 [source] | gross_charge | 2 weeks ago |
| 99212 | OP VISIT LEVEL 2 EST | $720 [source] | gross_charge | 2 weeks ago |
| 99213 | OP VISIT LEVEL 3 EST | $851 [source] | gross_charge | 2 weeks ago |
| 99214 | OP VISIT LEVEL 4 EST | $1,250 [source] | gross_charge | 2 weeks ago |
| C1713 | IMPLANT SPN 21 MEDIUM | $108,000 [source] | gross_charge | 2 weeks ago |
| C1725 | CATH ULTSND IVL 6X60MM | $49,070 [source] | gross_charge | 2 weeks ago |
| C1776 | INSERT TALUS CUSTOM LG | $108,000 [source] | gross_charge | 2 weeks ago |
| C1821 | IMPLNT SPN 8MM | $60,940 [source] | gross_charge | 2 weeks ago |
| C1874 | STENT EPRSTH 5MM 25CM | $58,897 [source] | gross_charge | 2 weeks ago |
| C1876 | SYSTEM EVAS 6MM 150CM | $26,189 [source] | gross_charge | 2 weeks ago |
| V2632 | LENS IOL +22.0 DIOP | $1,808 [source] | gross_charge | 2 weeks ago |