| Code | Description | Price | Price Type | Last Updated |
|---|---|---|---|---|
| 99211 | OP VISIT LEVEL 1 EST | $730 [source] | gross_charge | 2 weeks ago |
| 99212 | OP VISIT LEVEL 2 EST | $865 [source] | gross_charge | 2 weeks ago |
| 99213 | OP VISIT LEVEL 3 EST | $1,668 [source] | gross_charge | 2 weeks ago |
| 99214 | OP VISIT LEVEL 4 EST | $2,768 [source] | gross_charge | 2 weeks ago |
| C1713 | IMPLANT CRNL XL PEK CSTM | $285,075 [source] | gross_charge | 2 weeks ago |
| C1725 | CATH BLN PRPF 80MM 150CM | $68,935 [source] | gross_charge | 2 weeks ago |
| C1776 | IMPLANT MANDIBLE XL | $284,896 [source] | gross_charge | 2 weeks ago |
| C1821 | IMPLNT SPN 14MM | $69,726 [source] | gross_charge | 2 weeks ago |
| C1874 | STENT AOR 37ML 15CM 8MM | $414,208 [source] | gross_charge | 2 weeks ago |
| C1876 | STENT GRT EVAS 36X100MMM | $206,457 [source] | gross_charge | 2 weeks ago |
| V2787 | LENS INTRAOCLAR TORC | $5,374 [source] | gross_charge | 2 weeks ago |