| Code | Description | Price | Price Type | Last Updated |
|---|---|---|---|---|
| 29240 | Strap Shoulder LT * | $191 [source] | — | 4 years ago |
| 99211 | VISIT ESTABLISHED LEVEL 1 * | $702 [source] | — | 4 years ago |
| 99212 | VISIT ESTABLISHED LEVEL 2 * | $148 [source] | — | 4 years ago |
| 99213 | VISIT ESTABLISHED LEVEL 3 * | $179 [source] | — | 4 years ago |
| 99214 | VISIT ESTABLISHED LEVEL 4 * | $186 [source] | — | 4 years ago |
| C1776 | Joint device (implantable) * | $633 [source] | — | 4 years ago |
| V2632 | Posterior chamber intraocular lens * | $225 [source] | — | 4 years ago |
| V2787 | Astigmatism correcting function of intraocular lens * | $287 [source] | — | 4 years ago |