JRRMMC's Rates and Fees
Wards | Executive Suite | Suite | Private | Semi-Private |
---|---|---|---|---|
PAYWARD I | Php 2,500.00/day Room Nos. 4101 and 4102 | Php 1,500.00/day Rooms Nos. 4103,4105,4107, 4108,4109,4111 and 4114 | Php 900.00/day Male:Room Nos. 4104A-c;4112A-D Female:Rooms Nos. 4106A-c;4110A-C 4113A-D | |
PAYWARD II | Php 3,000.00/day Rooms No. 4201 | Php 2,500.00/day Room No. 4202 Php 2,200.00/day Room No. 4214 | Php 1,500.00/day Room Nos.4212 and 4203 to 4210 | Php 900.00/day Male: 4216 - Bed A-E Female: 4115 - Bed A-E |
ICU | Php 3,000.00/day | Php 2,800.00/day Php 2,300.00/day | Php 1,700.00/day | Php 1,300.00/day |
Burn Unit | Php 1,500.00/day | Php 1,500.00/day | Php 1,500.00/day | Php 900.00/day |
Item Code | Item Description | Item Price |
---|---|---|
LAB 0006 | BLood Gram Stain/Culture and Sensitivity | 730.00 |
LAB 0007 | Blood Gram Stain | 80.00 |
LAB 0008 | WOund Gram Stain/Culture and Sensitivity | 405.00 |
LAB 0009 | Wound Gram Stain | 80.00 |
LAB0010 | Wound Culture and Sensitivity | 325.00 |
LAB0002 | Sputum Gram Stain/Culture and Sensitivity | 405.00 |
LAB0005 | Cystology Gram Stain/Culture and Sensitivity | 405.00 |
LAB0004 | Cystology Gram Stain/Culture and Sensitivity | 80.00 |
LAB0009 | India Ink | 175.00 |
LAB001 | AFB Smear | 80.00 |
LAB0010 | Creatinine Clearance | 180.00 |
LAB004 | Aerobic Culture | 325.00 |
LAB005 | Aerobic Culture (Urine) | 325.00 |
LAB006 | Aerobic Culture (Stool) | 325.00 |
LAB007 | Aerobic Culture (Excudates) | 325.00 |
LAB008 | Aerobic Culture (CSF) | 325.00 |
LAB009 | RPR | 110.00 |
LAB010 | Hepatitis A Virus (HAV-IgM) | 230.00 |
LAB011 | Hepatitis | 230.00 |
LAB012 | HBSAG (RPHA) | 230.00 |
LAB013 | HBSAG (EIA) | 230.00 |
LAB014 | Anti-Hbc IgM | 350.00 |
LAB015 | Anti-Hbs | 220.00 |
LAB015 | Anti-Hbs | 220.00 |
LAB016 | Anti-Hbc/Hbs AG | 455.00 |
LAB017 | HBSAG (Strips) | 145.00 |
LAB018 | Hepa B Profile | 1180.00 |
LAB019 | Hepa C Profile | 1182.00 |
LAB020 | HCV (PA) | 335.00 |
LAB021 | HCV (EIA) | 415.00 |
LAB022 | HIV 1 & 2 | 310.00 |
LAB024 | HIV EIA | 415.00 |
LAB025 | ASO | 130.00 |
LAB026 | CRP | 130.00 |
LAB027 | Rheumatoid Factor | 130.00 |
LAB028 | Typhoid AG (Typhidot) | 945.00 |
LAB029 | Widal | 195.00 |
LAB030 | Dengue Antigen IgG | 650.00 |
LAB031 | Dengue Antigen IgM | 0.00 |
LAB032 | C3 | 165.00 |
LAB033 | Screening Fee | 1700.00 |
LAB034 | Whole Blood Screening Fee | 1700.00 |
LAB035 | Packed Red Blood Cells Screening Fee | 1700.00 |
LAB036 | PC, FFP, Cyoprecipitates, Crysupermante | 900.00 |
LAB038 | PSA (Prostatic Specific Antigen) | 950.00 |
LAB039 | Washing of PRBC | 500.00 |
LAB040 | ABO/RH Typing | 130.00 |
LAB098 | Amylase | 180.00 |
LAB082 | Blood Urea Nitrogen | 80.00 |
LAB080 | BLood Uric Acid | 90.00 |
LAB105 | Calcium | 140.00 |
LAB089 | Chloride | 140.00 |
LAB086 | Total Cholesterol | 90.00 |
LAB099 | CPK-MB | 955.00 |
LAB081 | Creatinine | 90.00 |
LAB079 | Glucose | 80.00 |
LAB084 | HDL/LDL (with Triglyceride and Cholesterol) | 675.00 |
LAB083 | Lipid Profile | 675.00 |
LAB088 | Potassium | 140.00 |
LAB092 | Serum Albumin | 80.00 |
LAB107 | Cross Matching | 195.00 |
LAB096 | SGOT | 140.00 |
LAB097 | SGPT | 140.00 |
LAB103 | Troponin I | 1,800.00 |
LAB111 | OGCT | 0.00 |
LAB087 | Sodium | 140.00 |
LAB090 | TP A/G Ratio | 155.00 |
LAB085 | Triglyceride | 195.00 |
LAB102 | HBAIC | 635.00 |
LAB047 | 24-Hours Urine TP Determination | 220.00 |
LAB050 | Fecalysis | 40.00 |
LAB051 | Occult Blood Test | 40.00 |
LAB048 | Pregnancy Test | 100.00 |
LAB049 | Semen Analysis | 90.00 |
LAB052 | Smear for Amoeba | 50.00 |
LAB053 | Stone Analysis | 320.00 |
LAB043 | Routine Urinalysis | 50.00 |
LAB045 | Urine Albumin (Qualilative) | 40.00 |
LAB044 | Urine Sugar (Qualilative) | 40.00 |
LAB063 | LEE Preparation (Manual) | 175.00 |
LAB061 | LEE & White, Cloting Time/Bleeding TIme | 50.00 |
LAB065 | Bone Marrow Aspiration | 520.00 |
LAB108 | Clotting Time/Bleeding Time | 50.00 |
LAB062 | Clot Retraction Time | 150.00 |
LAB056 | Complete Blood Count | 130.00 |
LAB067 | CSF Analysis (Complete) | 260.00 |
LAB068 | CSF Cell Count/Differential Count | 95.00 |
LAB069 | Sugar (FBS/RBS) | 80.00 |
LAB070 | Protein | 80.00 |
LAB058 | DIc Panel (PT, aPTT) | 485.00 |
LAB059 | Prothrobin TIme | 225.00 |
LAB060 | Activated Prothrobin Time | 260.00 |
LAB071 | ESR | 80.00 |
LAB072 | Malarial Smear (Slide) | 130.00 |
LAB066 | Osmotic Fragility Test | 240.00 |
LAB057 | Reticulocyte Count | 75.00 |
LAB106 | Schilling's Hemogram | 195.00 |
LAB113 | Complete Autopsy | 3,900.00 |
LAB12 | Beta HCG(H-Mode) | 750.00 |
LAB074 | Frozen Section | 710.00 |
LAB1 | Partial Autopsy | 1,950.00 |
LAB10 | IUFD and Disposition Fee | 100.00 |
LAB13 | Large/Radical (Breast, Uterus, RND) | 650.00 |
LAB14 | Histopath (Medium) | 455.00 |
LAB15 | PSA (Prostatic Specific Antigen) w/Dilution | 1,300.00 |
LAB11 | Arterial Blood Gas | 200.00 |
LAB09 | Fresh Frozen Plasma, Cryoprecipitate | 1,000.00 |
LAB055 | Direct Coomb's Test | 195.00 |
LAB08 | Indirect Coomb's Test | 160.00 |
LAB109 | Drug Test | 200.00 |
LAB073 | PAP's Smear | 130.00 |
LAB076 | Surgical Specimen (Small) | 325.00 |
LAB077 | Surgical Specimen (Medium) | 455.00 |
LAB078 | Surgical Specimen (Large) | 715.00 |
LAB046 | Urine Ketone (Qualilative) | 40.00 |
LAB064 | Peripheral Smear | 195.00 |
LAB091 | Total Protein | 80.00 |
LAB093 | Bilirubin (Total B1 and B2) | 195.00 |
LAB094 | ALP | 95.00 |
LAB095 | ACP | 225.00 |
LAB100 | LDH | 195.00 |
LAB101 | OGTT | 585.00 |
LAB104 | Beta HCG (H-Mole) with Dilution | 950.00 |
LAB110 | HDL | 390.00 |
LAB117 | Histopath (Large) | 715.00 |
LAB118 | Histopath | 780.00 |
LAB119 | Alkaline Phosphatase | 95.00 |
LAB112 | HAT | 310.00 |
LAB120 | Cell Cytology | 325.00 |
LAB121 | (ER) Immunohistochemistry Tests | 1,882.40 |
LAB122 | (PR) Immunohistochemistry Tests | 1,882.40 |
LAB123 | (HER2) Immunohistochemistry Tests | 1,882.40 |
LAB125 | ANA (SLE) | 610.00 |
LAB126 | ANA (SLE) with Dilution | 950.00 |
LAB127 | Anti-Cardiolipin IgG | 2,650.00 |
LAB128 | Anti-Cardiolipin IgM | 2,650.00 |
LAB129 | Anti-Hav IgG | 400.00 |
LAB130 | Anti-HAV IgM | 375.00 |
LAB131 | Anti-Hbc Total | 350.00 |
LAB132 | Anti-Hbc | 340.00 |
LAB133 | D-DImer | 3,100.00 |
LAB134 | Dengue NS1 Qualilative | 1220.00 |
LAB135 | Dengue Screening IgM/IgG | 890.00 |
LAB136 | HbeAg | 340.00 |
LAB137 | Leptospira IgG and IgM Screening (LAT IgM IgM) | 750.00 |
LAB138 | Treponema Pallidum-Particle Agglution (Qualitative) | 360.00 |
LAB139 | Treponema Pallidum-Particle Agglution with Dilution | 1,300.00 |
LAB140 | Alpha Feto Protein | 675.00 |
LAB141 | Alpha Feto Protein with Dilution | 935.00 |
LAB142 | CA125 Ovarian CA | 1,450.00 |
LAB143 | CA125 Ovarian Ca with Dilution | 1,900.00 |
LAB144 | CEA | 675.00 |
LAB145 | CEA with Dilution | 900.00 |
LAB146 | Stool Concentration Technique | 250.00 |
LAB147 | H. Pylori Stool Antigen | 1,600.00 |
LAB148 | Micra Test | 240.00 |
LAB149 | Urine RBC Morphology | 75.00 |
LAB150 | Fungal CUlture | 275.00 |
LAB151 | Ameoba Concentration Technique | 275.00 |
LAB152 | Hemoglobin Electrophoresis | 275.00 |
LAB154 | Lupus Anticoagulan | 3,000.00 |
LAB155 | Ammonia (NH4) | 825.00 |
LAB156 | C3 Compliment 3 | 500.00 |
LAB157 | G6PD | 1,100.00 |
LAB16 | Histopath (Small) | 325.00 |
LAB17 | Blood Washing | 300.00 |
OB001 | Endometrial Biopsy | 325.00 |
LAB158 | High Sensitivity CRP | 600.00 |
LAB159 | Ionized Calcium | 440.00 |
LAB161 | Microalbumin/ Creatinine Ratio | 1,500.00 |
LAB162 | Phosphorus | 200.00 |
LAB163 | TIBC with Iron | 650.00 |
LAB164 | Transferrin Saturation | 650.00 |
LAB165 | Follicle Stimulating Hormone | 600.00 |
LAB166 | Cortisol | 575.00 |
LAB167 | LH | 650.00 |
LAB168 | Prolacticin | 600.00 |
LAB170 | CA19-9 | 1,800.00 |
LAB171 | CA19-9 with Dilution | 2,200.00 |
LAB172 | Blood CS Adult HP | 1,800.00 |
LAB173 | Blood CS Pedia HP | 2,000.00 |
Item Code | Item Description | Item Price |
---|---|---|
CVU003 | 2D ECHOCARDIOGRAPHY-ADULT | 2,500.00 |
CVU004 | 2D ECHOCARDIOGRAPHY-PEDIA | 2,600.00 |
CVU1 | ELECTROCARDIOGRAPHY-ADULT | 210.00 |
CVU002 | ELECTROCARDIOGRAPHY-PEDIA | 0 |
CVU011 | 24 HR HOLTER MONITORING | 3,100.00 |
PMSC018 | ECG | 210.00 |
CVU112 | TREADMILL STRESS TEST | 1,100.00 |
Item Code | Item Description | Item Price |
---|---|---|
PSY001 | PSYCHOLOGICAL TESTING | 100.00 |
PSY0010 | NEURO-PSYCHIATRIC CLEARANCE | 300.00 |
PSY002 | PSYCHOLOGICAL TEST RESULTS COPY | 300.00 |
PSY003 | NEURO-PSYCHIATRIC EVALUATION | 300.00 |
PSY004 | PSYCHOMETRIC EXAMINATIONS-OUTSIDE REFERRALS | 300.00 |
PSY005 | PSYCHOMETRIC EXAM. -HOSPITAL BASED | 200.00 |
PSY006 | PSYCHOLOGICAL\CLINICAL TEST | 200.00 |
PSY007 | NEURO-PSYCHIATRIC CLEARANCE: NATURALIZATION-EMPLOYMENT ABROAD | 0 |
PSY008 | NEURO-PSYCHIATRIC CLEARANCE: FELLOWSHIP-GOVERNMENT AND OTHER | 500.00 |
Item Code | Item Description | Item Price |
---|---|---|
NUC001 | THYROID SCAN TC99M | 800.00 |
NUC002 | Blood Gram Stain | 3,000.00 |
NUC003 | SCINTIMAMMO TC99M HDP | 6,105.00 |
NUC004 | TSH | 415.00 |
NUC005 | FT3 | 410.00 |
NUC006 | FT4 | 410.00 |
NUC007 | FT3,FT4,TSH COMBO | 1,235.00 |
NUC008 | RENAL SCAN (DTPA) | 4,645.00 |
NUC009 | RENAL SCAN (DMSA) | 4,560.00 |
NUC010 | RENAL SCAN LASIX | 3,800.00 |
NUC011 | HEPATOBILIARY SCAN | 3,500.00 |
NUC012 | WHOLE BODY I-131(3-5mCi) SCAN | 4,815.00 |
NUC013 | GI BLEED STUDY | 5,000.00 |
NUC014 | LYMPHSCINTIGRAPHY | 5,500.00 |
NUC015 | TESTICULAR SCAN | 4,890.00 |
NUC016 | MECKEL'S SCAN | 4,370.00 |
NUC017 | SCINTIBONE COMBO | 5,000.00 |
NUC019 | THYROID I-131 SCAN | 2,500.00 |
NUC020 | THYROID SCAN W/ PERFUSION | 50.00 |
NUC021 | EXTRA COPY OF RIA RESULT | 230.00 |
NUC022 | FT3,TSH ) | 820.00 |
NUC23 | FT4,TSH | 820.00 |
NUC024 | FT3,FT4 | 820.00 |
NUC025 | RENAL SCAN CATOPRIL | 4,645.00 |
NUC029 | RENAL SCAN (DIURETICS) | 4,645.00 |
NUC030 | HIDA SCAN | 4,845.00 |
NUC031 | GI BLEED SCAN | 10,625.00 |
NUC032 | LIVER & SPLEEN SCAN | 7,080.00 |
NUC033 | TI-201 (S-R) | 17,590.00 |
NUC034 | MIBI (S-R) | 14,515.00 |
NUC035 | STRESS OR REST ONLY | 310.00 |
NUC036 | 3mCI | 4,815.00 |
NUC037 | BONE DENSITOMETRY | 2,500.00 |
NUC038 | THYROID SCAN | 1,045.00 |
NUC039 | BONE SCAN HDP (ROUTINE) | 5,105.00 |
NUC041 | BONE SCAN HDP (SCINTIMAMMO) | 6,105.00 |
NUC042 | RENAL SCAN (CAPTOPRIL) | 4,645.00 |
NUC043 | (20%) FT3, FT4, TSH | 988.00 |
NUC044 | (20%) FT3, TSH | 656.00 |
NUC045 | (20%) FT4, TSH | 656.00 |
NUC046 | (20%) FT3, FT4 | 656.00 |
NUC047 | (20%) FT3 | 328.00 |
NUC048 | (20%) FT4 | 328.00 |
NUC049 | (20%) TSH | 332.00 |
NUC050 | (30%) FT3, FT4, TSH | 865.00 |
NUC051 | (30%) FT3, TSH | 575.00 |
NUC052 | (30%) FT4, TSH | 575.00 |
NUC053 | (30%) FT3 | 575.00 |
NUC054 | (30%) FT4 | 287.00 |
NUC055 | (30%) TSH | 290.00 |
NUC056 | (20%) THYROID SCAN | 836.00 |
NUC057 | (20%) TS with PERFUSION | 880.00 |
NUC058 | (30%) TS with PERFUSION | 770.00 |
NUC059 | (30%) THYROID SCAN | 730.00 |
NUC060 | (20%) BONE SCAN-Routine | 4,084.00 |
NUC061 | ((20%) BONE SCAN-With 3 Phase | 4,884.00 |
NUC062 | (20%) BONE SCAN-With SCINTIMAMMO | 4,884.00 |
NUC063 | (30%) BONE SCAN- ROUTINE | 3,570.00 |
NUCMED001 | THYROID SCAN TC99M | 1,000.00 |
NUCMED | Bone densitometry (routine) | 5,105.00 |
Nucmed1 | DXA (WHOLE BODY) | 3,500.00 |
NUCMED40 | SCINTIMMAMOGRAPHY | 4,000.00 |
NUCMED028 | RENAL SCAN (GFR) | 2,880.00 |
NUC064 | BONE SCAN WITH 3 PHASE | 4,270.00 |
NUC065 | BONE SCAN-WITH SCINTIMAMMO | 4,270.00 |
NUC069 | SCINTIMAMMOGRAPHY | 3,200.00 |
NUC070 | SCINTIMAMMOGRAPHY | 2,800.00 |
NUC071 | RENAL SCAN-DTPA | 3,716.00 |
NUC072 | RENAL SCAN WITH DIURETICS | 3,716.00 |
NUC073 | RENAL SCAN-DMSA | 3,648.00 |
NUC074 | RENAL SCAN-CAPTOPRIL | 3,716.00 |
NUC075 | RENAL SCAN-GFR | 2,304.00 |
NUC076 | RENAL SCAN-DTPA | 3,250.00 |
NUC077 | RENAL SCAN-DMSA | 3,190.00 |
NUC078 | (30%) RENAL SCAN-CAPTOPRIL | 3,250 |
NUC079 | (30%) RENAL SCAN-GFR | 2,020.00 |
NUC080 | (30%) RENAL SCAN-WITH DIURETICS | 3,250.00 |
NUC081 | (30%) TSH | 290.00 |
NUC082 | GI BLEED SCAN | 7,440.00 |
NUC083 | TESTICULAR SCAN | 3,912.00 |
NUC084 | LIVER & SPLEEN SCAN | 5,664.00 |
NUC085 | HIDA SCAN | 3,390.00 |
NUC086 | GI BLEED SCAN | 7,440.00 |
NUC087 | TESTICULAR SCAN | 3,420.00 |
NUC088 | LIVER & SPLEEN SCAN | 4,950.00 |
NUC089 | MYOCARDIAL PERFUSION-TI-201 (S-R) | 14,072.00 |
NUC090 | MYOCARDIAL PERFUSION-MIBI (S-R) | 11,612.00 |
NUC091 | MYOCARDIAL PERFUSION-STRESS OR REST ONLY | 6,400.00 |
NUC092 | MYOCARDIAL PERFUSION-TI-201 (s-R) | 12,310.00 |
CT-Scan Procedures
Item Code | Item Description | Item Price | |||
---|---|---|---|---|---|
32 | Abdominal/Thoracic/Renal/Ext (Angio) | 6,000.00 | |||
33 | CT Myelo | 3350.00 | |||
CT SCAN | Zygoma | 5700.00 | |||
CT001 | Cranial (Plain) | 2,350.00 | |||
CT004 | Orbital CT Scan (Plain) | 2,350.00 | |||
CT029 | Orbital CT Scan (Contrast) | 5,580.00 | |||
CT122 | Cranial (Contrast) | 5,500.00 | |||
CT002 | Sella CT Scan | 3100.00 | |||
CT003 | Cranial w/Facial Axial/Coronal Cuts (Contrast) | 7,100.00 | |||
CT0130 | Cranial w/Orbital Cuts (Contrast) | 7,100.00 | |||
CT005 | Cranial w/2MM Posterior Fossae | 4100.00 | |||
CT0056 | Cranial w/Orbital Cuts (Plain) | 4,250.00 | |||
CT006 | PNS (Plain) | 2,350.00 | |||
CT007 | PNS (Contrast) | 5,580.00 | |||
CT008 | Orbits | 3100.00 | |||
CT009 | Neck-Routine | 3100.00 | |||
CT010 | Nasopharynx or Oral Cavity (Plain) | 2,650.00 | |||
CT011 | Chest (Plain) | 2,650.00 | |||
CT121 | Chest (Contrast) | 7,340.00 | |||
CT012 | Chest (High Resolution) | 4,500.00 | |||
CT013 | Chest w/ Adrenal Cuts | 5,200.00 | |||
CT014 | Lower Abdomen (Routine) | 2,350.00 | |||
CT124 | Lower Abdomen (Contrast) | 6,970.00 | |||
CT015 | Whole Abdomen (Plain/Contrast) | 11,800.00 | |||
CT016 | Cervical Spine (Contrast) | 4,100.00 | |||
CT017 | Thoracic Spine (Plain) | 2,350.00 | |||
CT0132 | Thoracic Spine (Contrast) | 7,340.00 | |||
CT018 | Lumbar or Lumbosacral Spine (Plain) | 2,680.00 | |||
CT133 | Lumbar or Lumbosacral Spine | 7,340.00 | |||
CT019 | Lower Extrermities (Contrast) | 6,120.00 | |||
CT126 | Lower Extrermities (Plain) | 2,650.00 | |||
CT020 | CT Guided Biopsy | 6,340.00 | |||
CT021 | CT Stonogram | 2,680.00 | |||
CT022 | Upper Abdomen (Contrast) | 6,970.00 | |||
CT023 | Upper Abdomen (Routine) | 2,350.00 | |||
CT024 | Cranial w/ Facial Axial/Coronal Cuts (Plain) | 4,250.00 | |||
CT025 | Cranial w/ Temporal Bone (Plain) | 4,250.00 | |||
CT129 | Cranial w/ Temporal Bone (Contrast) | 7,100.00 | |||
CT026 | Cranial w/ Paranasal Sinuses (Plain) | 4,250.00 | |||
CT131 | Cranial w/ Paranasal Sinuses (Contrast) | 7,100.00 | CT027 | Neck Routine w/ Oral Cavity (Contrast) | 5,700.00 |
CT028 | Neck/Zygoma to Clavicle (Plain) | 2,650.00 | |||
CT029 | Orbital w/ Axial-Coronal Cuts (Contrast) | 4,100.00 | |||
CT030 | Pelvis (Plain) | 2,350.00 | |||
CT030 | Pelvis (Contrast) | 6,970.00 | |||
CT031 | PNS w/ Axial-Coronal Cuts (Contrast) | 4100.00 | |||
CT032 | PNS w/ Temporal Cuts (Plain/Contrast) | 5100.00 | |||
CT033 | Sella Turcica | 3100.00 | |||
CT034 | Whole Abdomen (Triphasic) | 12,900.00 | |||
CT035 | Temporal Bone (Contrast) | 5,580.00 | |||
CT040 | Temporal Bone (Plain) | 2,350.00 | |||
CT036 | Orbits w/ Axial/Coronal Cuts (Contrast) | 4100.00 | |||
CT037 | Paranasal Sinuses w/ Axial/Coronal Cuts (Contrast) | 4100.00 | |||
CT038 | Additional Cuts | 1,110.00 | |||
CT039 | Facial (Plain) | 2,350.00 | |||
CT0123 | Facial (Contrast) | 5,580.00 | |||
CT057 | Cervical Spine (Plain) | 2,650.00 | |||
CT016 | Cervical Spine (Contrast) | 7,340.00 | |||
CT100 | CT Scan w/ Temporal Cuts | 5100.00 | |||
CT111 | Pulmonary | 8300.00 | |||
CT112 | Neck Routine CT w/ Contrast | 7,340.00 | |||
CT113 | Nasorpharynx or Oral Cavity (Contrast) | 7,340.00 | |||
CT114 | CT Urography | 7,920.00 | |||
CT201 | Thoracolumbar CT-Scan | 7300.00 | |||
XRY102 | Angiography: Brain/Neck | 5000.00 | |||
XRY103 | Angiography: Thoracic/ABD. Aorta/Renal/Ext | 6000.00 | |||
CT204 | Extrimities (Upper) | 2,650.00 |
X-RAY Procedures
XRY059Shoulder Xray360.00Item Code | Item Description | Item Price |
---|---|---|
91 | Intra-Operative Xray | 1000.00 |
PRO1152 | Abdominal Xray | 400.00 |
PRO234 | Urethrogram | 1000.00 |
UTZ052 | Mammography | N/A |
XRAY0002 | Additional Shot | 40.00 |
XRAY1649 | Skeletal Survey | N/A |
XRY | Cervico Thoracic | 330.00 |
XRY0012 | Chest Adult Xray | 250.00 |
XRY002 | Ankle Joint Xray | 530.00 |
XRY003 | Antegrade Pyelography | 4,800.00 |
XRY004 | Baby Gram Xray | 990.00 |
XRY005 | Barium Enema Xray | 3,960.00 |
XRY006 | Cervical Spine Xray | 530.00 |
XRY007 | Cervical Spine w/Obliques Xray | 530.00 |
XRY008 | Cervicothoracic Xray | 600.00 |
XRY009 | Chest Adult Xray | 530.00 |
XRY010 | Chest Child Xray | 530.00 |
XRY011 | High Towne's View Xray | 350.00 |
XRY012 | Cystography | 4800.00 |
XRY013 | Clavicle Xray | 360.00 |
XRY015 | Coccyx Xray | 200.00 |
XRY016 | Distal Colonography Xray | 3,960.00 |
XRY017 | Elbow Xray | 530.00 |
XRY018 | Esophagram/Meglumine Swallow | 2,760.00 |
XRY020 | Femur/Thigh Xray | 530.00 |
XRY022 | Fistulography | 3,840.00 |
XRY023 | Forearm Xray | 530.00 |
XRY024 | Foot Xray | 530.00 |
XRY025 | Hip Joint/Frog Leg Xray | 530.00 |
XRY026 | Hand Xray | 530.00 |
XRY027 | Humerus/Arm Xray | 530.00 |
XRY028 | Hypotonic Duodenography Xray | 1500.00 |
XRY029 | Hysterosalpingography | 3,840.00 |
XRY030 | Invetography Xray | 1300.00 |
XRY031 | IVP Xray | 4,960.00 |
XRY032 | IVP Hypertensive Xray | 4,960.00 |
XRY033 | KUB Xray | 390.00 |
XRY034 | Knee Xray | 530.00 |
XRY035 | Leg Xray | 530.00 |
XRY036 | Lordoto/Apicogram Xray | 530.00 |
XRY037 | Lumbo Sacrarl Xray | 990.00 |
XRY038 | Lumbar Both Oblques Xray | N/A |
XRY039 | Mandible Xray | 530.00 |
XRY040 | Mastoids Xray | 530.00 |
XRY041 | Myelogram | N/A |
XRY042 | Nasal Bone Xray | 530.00 |
XRY043 | Nasopharynx Xray | 0.00 |
XRY044 | Neck Xray | 530.00 |
XRY045 | Operative Cholangiography Xray | 1,000.00 |
XRY046 | Optic Foramen/Caldwel Xray | 0.00 |
XRY047 | Oral Cholecystography Xray | 0.00 |
XRY048 | Orbit Xray | 0.00 |
XRY049 | Parallax View Xray | 0.00 |
XRY055 | Retrograde Pyelography Xray | 4,800.00 |
XRY053 | Plain Abdomen Child Xray | 530.00 |
XRY054 | Plain Abdomen adult Xray | 530.00 |
XRY050 | Paranasal Sinuses Xray | 200.00 |
XRY051 | Pelvis Xray | 360.00 |
XRY052 | Pelvimentary Xray | 500.00 |
XRY056 | Sacro Coccygeal Xray | 200.00 |
XRY057 | Scoliotic Series Xray | 1,520.00 |
XRY060 | Scapula Xray | 360.00 |
XRY061 | Sella Turcica Xray | 350.00 |
XRY062 | Skull Xray | 530.00 |
XRY066 | Submandibular Xray | 250.00 |
XRY063 | Sialography | 0.00 |
XRY064 | Small Intestine Series Xray (Water Soluble) | 6,470.00 |
XRY064 | Small Intestine Series Xray (Barrium) | 3,590.00 |
XRY065 | Sternum Xray | 0.00 |
XRY067 | T-TUbe Cholangiogram | 3,860.00 |
XRY068 | TMJ Xray | 0.00 |
XRY069 | Thoracolumbar Spine Xray | 990.00 |
XRY070 | Thoraco Lumber Obliques Xray | 990.00 |
XRY071 | Thoracic Cage Xray | 300.00 |
XRY073 | Upper GI Series Xray | 2,760.00 |
XRY074 | Voiding Cystourethrogram Xray | 1,000.00 |
XRY075 | Ventriculogram | 1,170.00 |
XRY076 | Wrist Joint Xray | 530.00 |
XRY077 | SMV (Zygoma) Xray | 530.00 |
XRY078 | STL-Nose Xray | 530.00 |
XRY079 | Swimmer's View Xray | 300.00 |
XRY080 | Caldwell's View Xray | 530.00 |
XRY082 | Additional Caldwell's view Xray | 40.00 |
XRY083 | Additional Mortise view Xray | 40.00 |
XRY084 | Additional Water's view Xray | 40.00 |
XRY085 | Additional Oblique view Xray | 40.00 |
XRY081 | Additional Axillary view Xray | 40.00 |
XRY123 | Baurium Swallow/Modified | 3,960.00 |
XRY11 | Chest PA Adult- PA Lateral | 530.00 |
XRY13 | Chest PA Child- PA Lateral | 530.00 |
XRY14 | Chole -GI Series | 530.00 |
XRY17 | Dorsal Vertebral/Thoracic Spine | 530.00 |
XRY18 | Dorsal Vertebral-Thoracic Spine | 530.00 |
XRY19 | Esophagography (Barium Swallow) | 530.00 |
XRY22 | Intravenous Pyelography (IVP) | 4,960.00 |
XRY34 | STL Neck | 530.00 |
XRY086 | Fluoroscopy | N/A |
XRY369 | 650.00 | |
XRY370 | Cross Table Lateral Hip | 450.00 |
XRY101 | Angiogram | 5000.00 |
XRY104 | Cystourethrography (CUG)/VCUG | 1000.00 |
XRY105 | KUB-IVP | 1100.00 |
Ultrasound Procedures
Item Code | Item Description | Item Price |
---|---|---|
UTZ001 | Upper Abdominal Ultrasound | 600.00 |
XRY0006 | Cardiac Ultrasound | 810.00 |
UTZ002 | HBT/Liver Ultrasound | 640.00 |
UTZ003 | KUB Ultrasound | 770.00 |
UTZ004 | Cranial Ultrasound | 810.00 |
UTZ005 | Thyroid/ Neck Ultrasound | 650.00 |
UTZ006 | KUB + Prostate Ultrasound | 990.00 |
UTZ007 | Soft Tissue Ultrasound | 640.00 |
UTZ008 | Inguino-Scrotal Ultrasound | 1,060.00 |
UTZ009 | Transrectal Ultrasound | 800.00 |
UTZ010 | Breast/Sonomamogram Ultrasound | 860.00 |
UTZ011 | Fast Ultrasound | 940.00 |
UTZ012 | UTZ Guided Biopsy | 2,620.00 |
UTZ013 | Utrasound Guided Nephrostomy | 2,000.00 |
UTZ014 | UTZ Guided Para/Thoracenthesis | 2,000.00 |
UTZ015 | Thoracic/Lung Ultrasound | 640.00 |
UTZ016 | Whole Abdomen Ultrasound | 940.00 |
UTZ027 | Whole Abdomen Ultrasound with Prostate | 1,030.00 |
UTZ017 | Carotid Doppler Ultra | 2,000.00 |
UTZ018 | Bilateral upper/lower Extremities-arterial or venous, doppler ultrasound | 3,000.00 |
UTZ019 | Bilateral Extremities-arterial & venous doppler ultrasound | 3,000.00 |
UTZ020 | Single Extremity arterial/venous doppler ultrasound | 2,500.00 |
UTZ021 | Single Extremity- arterial & venous doppler ultradound | 3,000.00 |
UTZ022 | Thoracic Spine | 2,000.00 |
UTZ031 | Prostate Ultrasound | 600.00 |
UTZ024 | Abdominal Doppler Ultrasound | 1,400.00 |
UTZ032 | Transbdominal Ultrasound | 680.00 |
UTZ025 | Dopper UTZ of Mass | 1,400.00 |
UTZ026 | LGBPS Ultrasound | 640.00 |
UTZ027 | WAB and Prostate UTZ | 1,000.00 |
UTZ06 | Transcranial Ultrasound | 2,300.00 |
UTZ029 | Liver Ultrasound | 600 |
XRY45 | Bio-Physical Scoring | 600.00 |
Magnetic Resonance Procedures
Item Code | Item Description | Item Price |
---|---|---|
MRI0010 | Cranial MRI (Plain) | 6,230.00 |
MRI011 | Cranial MRI (Contrast) | 12,560.00 |
MRI002 | Head Stroke IAC Sella MRI | 6,050.00 |
MRI003 | Neck MRI | 5,550.00 |
MRI045 | Chest MRI (Plain) | 6,230.00 |
MRI047 | Chest MRI (Contrast) | 13,880.00 |
MRI0021 | Cervical Spine MRI (Plain) | 6,230.00 |
MRI0023 | Cervical Spine MRI (Plain) | 12,560.00 |
MRI0075 | Knee MRI (Plain) | 12,560.00 |
MRI00073 | Knee MRI (Contrast) | 6,230.00 |
MRI0053 | Shoulder MRI (Plain) | 6,230.00 |
MRI0055 | Shoulder MRI (Contrast) | 12,560.00 |
MRI008 | Hip/Bony Pelvis MRI | 5500.00 |
MRI0014 | Orbit MRI (Plain) | 6,230.00 |
MRI0015 | Orbit MRI (Contrast) | 12,560.00 |
MRI0011 | Facial MRI (Plain) | 2,230.00 |
MRI0011 | Facial MRI (Plain) | 6,230.00 |
MRI0019 | Facial MRI (Contrast) | 12,560.00 |
MRI0025 | Thoracic MRI (Plain) | 6,230.00 |
MRI0027 | Thoracic MRI (Contrast) | 12,560.00 |
MRI0029 | Lumbar/Lumbosacral Spine MRI (Plain) | 6,230.00 |
MRI0031 | Lumbar/Lumbosacral Spine MRI (Contrast) | 12,560.00 |
MRI0041 | Whole Abdomen MRI (Plain) | 7,550.00 |
MRI0043 | Whole Abdomen MRI (Contrast) | 16,520.00 |
MRI0049 | Pelvis MRI (Plain) | 6,230.00 |
MRI0051 | Pelvis MRI (Contrast) | 12,560.00 |
MRI0057 | Elbow MRI (Plain) | 6,230.00 |
MRI0059 | Pelvis MRI (Contrast) | 12,560.00 |
MRI0061 | Hand/Wrist MRI (Plain) | 6,230.00 |
MRI0063 | Hand/Wrist MRI (Contrast) | 12,560.00 |
MRI0065 | Upper Extremity MRI (Plain) | 7,550.00 |
MRI0067 | Upper Extremity MRI (Contrast) | 13,880.00 |
MRI0069 | Femur/Leg MRI (Plain) | 7,550.00 |
MRI0071 | Femur/Leg MRI (Contrast) | 13,880.00 |
MRI0077 | Foot/Ankle MRI (Plain) | 6,230.00 |
MRI0079 | Foot/Ankle MRI (Contrast) | 12,560.00 |
MRI0081 | MRA MRI (Plain) | 6,230.00 |
MRI0083 | MRA MRI (Contrast) | 12,560.00 |
MRI0085 | MRCP MRI (Plain) | 7,550.00 |
MRI0879 | MRCP MRI (Contrast) | 13,880.00 |
MRI0089 | Prostate MRI (Plain) | 6,230.00 |
MRI0091 | Prostate MRI (Contrast) | 12,560.00 |