| Level I Debridement & Destruction | $23.00 | $8.00 | $91.09 | 28 out of 291 | Details | 
  | Level Ii Debridement & Destruction | $112.00 | $55.00 | $262.58 | 174 out of 1479 | Details | 
  | Level Iii Debridement & Destruction | $195.00 | $98.00 | $362.13 | 234 out of 1534 | Details | 
  | Level I Excision/ Biopsy | $558.00 | $244.00 | $2,264.47 | 83 out of 445 | Details | 
  | Level Ii Excision/ Biopsy | $868.00 | $309.00 | $3,430.88 | 54 out of 1060 | Details | 
  | Level Iii Pulmonary Treatment | $216.00 | $122.00 | $593.80 | 181 out of 2304 | Details | 
  | Level Ii Noninvasive Physiologic Studies | $370.00 | $268.00 | $751.36 | 287 out of 1889 | Details | 
  | Level I Nerve Injections | $341.00 | $172.00 | $1,279.79 | 135 out of 1657 | Details | 
  | Level Ii Nerve Injections | $1,343.00 | $1,092.00 | $1,342.70 | 484 out of 769 | Details | 
  | Level Iii Nerve Injections | $1,200.00 | $738.00 | $2,577.32 | 281 out of 2002 | Details | 
  | Level Ii Extended Eeg, Sleep, And Cardiovascular Studies | $2,950.00 | $2,209.00 | $3,631.53 | 706 out of 1967 | Details | 
  | Level I Diagnostic And Screening Ultrasound | $260.00 | $201.00 | $487.04 | 360 out of 2739 | Details | 
  | Level Iii Diagnostic And Screening Ultrasound | $586.00 | $441.00 | $1,057.55 | 450 out of 2998 | Details | 
  | Level Ii Echocardiogram Without Contrast | $1,406.00 | $1,023.00 | $1,970.56 | 943 out of 2898 | Details | 
  | Level Iii Echocardiogram Without Contrast | $1,415.00 | $878.00 | $3,033.90 | 110 out of 1164 | Details | 
  | Magnetic Resonance Imaging And Magnetic Resonance Angiography Wit | $1,363.00 | $960.00 | $2,611.02 | 181 out of 2855 | Details | 
  | Level Ii Pulmonary Tests | $140.00 | $83.00 | $316.27 | 215 out of 2248 | Details | 
  | Level Ii Cardiac Imaging | $1,906.00 | $1,186.00 | $4,574.47 | 93 out of 2564 | Details | 
  | Level 2 Hospital Clinic Visits | $77.00 | $6.00 | $202.38 | 31 out of 2116 | Details | 
  | Level 5 Hospital Clinic Visits | $215.00 | $54.00 | $454.23 | 84 out of 634 | Details | 
  | Level I Electronic Analysis Of Devices | $74.00 | $41.00 | $182.68 | 90 out of 569 | Details | 
  | Level Ii Electronic Analysis Of Devices | $443.00 | $338.00 | $705.38 | 196 out of 457 | Details |