| Code | Description | Price | Price Type | Last Updated |
|---|---|---|---|---|
| 29240 | Strap Shoulder LT * | $182 [source] | — | 4 years ago |
| 99211 | VISIT ESTABLISHED LEVEL 1 * | $140 [source] | — | 4 years ago |
| 99212 | VISIT ESTABLISHED LEVEL 2 * | $154 [source] | — | 4 years ago |
| 99213 | VISIT ESTABLISHED LEVEL 3 * | $200 [source] | — | 4 years ago |
| 99214 | VISIT ESTABLISHED LEVEL 4 * | $181 [source] | — | 4 years ago |
| C1713 | Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) * | $148 [source] | — | 4 years ago |
| C1776 | Joint device (implantable) * | $3,042 [source] | — | 4 years ago |
| C1874 | Stent, coated/covered, with delivery system * | $4,311 [source] | — | 4 years ago |
| C1876 | Stent, non-coated/non-covered, with delivery system * | $3,093 [source] | — | 4 years ago |
| V2632 | Posterior chamber intraocular lens * | $386 [source] | — | 4 years ago |
| V2787 | Astigmatism correcting function of intraocular lens * | $847 [source] | — | 4 years ago |