| Code | Description | Price | Price Type | Last Updated |
|---|---|---|---|---|
| 99211 | VISIT ESTABLISHED LEVEL 1 * | $24 [source] | — | 4 years ago |
| 99212 | VISIT ESTABLISHED LEVEL 2 * | $67 [source] | — | 4 years ago |
| 99213 | VISIT ESTABLISHED LEVEL 3 * | $131 [source] | — | 4 years ago |
| 99214 | VISIT ESTABLISHED LEVEL 4 * | $201 [source] | — | 4 years ago |
| C1725 | Catheter, transluminal angioplasty, non-laser (may include guidance, infusion/perfusion capability) * | $1,450 [source] | — | 4 years ago |
| C1876 | Stent, non-coated/non-covered, with delivery system * | $7,273 [source] | — | 4 years ago |
| V2632 | Posterior chamber intraocular lens * | $373 [source] | — | 4 years ago |
| V2787 | Astigmatism correcting function of intraocular lens * | $1,229 [source] | — | 4 years ago |