| Code | Description | Price | Price Type | Last Updated |
|---|---|---|---|---|
| 99211 | OP VISIT LEVEL 1 EST | $285 [source] | gross_charge | 2 weeks ago |
| 99212 | OP VISIT LEVEL 2 EST | $314 [source] | gross_charge | 2 weeks ago |
| 99213 | OP VISIT LEVEL 3 EST | $580 [source] | gross_charge | 2 weeks ago |
| 99214 | OP VISIT LEVEL 4 EST | $454 [source] | gross_charge | 2 weeks ago |
| C1713 | IMPLANT PLATE CRNL CSTM | $35,245 [source] | gross_charge | 2 weeks ago |
| C1725 | CATH BLNDIL 2MM 10MM | $10,197 [source] | gross_charge | 2 weeks ago |
| C1776 | CMPNT FEM KN LT 76X66MM | $67,820 [source] | gross_charge | 2 weeks ago |
| C1821 | IMPLNT SPN 10MM | $38,719 [source] | gross_charge | 2 weeks ago |
| C1874 | STENT PANC 15MM 15MM | $28,193 [source] | gross_charge | 2 weeks ago |
| C1876 | STENT DUODENAL 22X120MM | $14,297 [source] | gross_charge | 2 weeks ago |
| V2787 | LENS IOL +6.0 DIOP | $6,139 [source] | gross_charge | 2 weeks ago |