OPD Rates

Department	Item ID	Item Description	Outpatient	Range in ₱
Laboratory	LAB00002	ACID FAST STAIN		300 – 400
Laboratory	LAB00388	AFP		2,000 – 3000
Laboratory	LAB00005	ALBUMIN		300 – 400
Laboratory	LAB00119	ALDOSTERONE		2,000 – 3,000
Laboratory	LAB00006	ALKALINE PHOSPHATASE		300 – 400
Laboratory	LAB00007	AMMONIA		700 – 800
Laboratory	LAB00008	AMYLASE		300 – 400
Laboratory	LAB00317	ANTI HAV IGM, QUALITATIVE		300 – 400
Laboratory	LAB00393	ANTI HBeAg, VIDAS		1,000 – 2,000
Laboratory	LAB00010	ANTI HBS		800 – 1,000
Laboratory	LAB00011	ANTI HCV		1,000 – 2,000
Laboratory	LAB00361	ANTIBODY SCREENING		1,500 – 2,000
Laboratory	LAB00013	APTT		600 – 1,000
Laboratory	LAB00014	ASO, QUALITATIVE		500 – 1,000
Laboratory	LAB00015	ASO, QUANTITATIVE		1,700 – 2,000
Laboratory	LAB00034	BILIRUBIN, DBIB / IBIB		500 – 600
Laboratory	LAB00230	BILIRUBIN, TOTAL		500 – 600
Laboratory	LAB00016	BLEEDING TIME		150 – 200
Laboratory	LAB00265	BLOOD BANK, FFP		1,000 – 1,500
Laboratory	LAB00038	BLOOD BANK, FWB		1,800 – 2,000
Laboratory	LAB00094	BLOOD BANK, PLATELET CONCENTRATE		1,000 – 1,500
Laboratory	LAB00264	BLOOD BANK, PRBC		1,500 – 2,000
Laboratory	LAB00360	BLOOD BANK, PROCESSING FEE		1,800 – 2,200
Laboratory	LAB00018	BLOOD TYPING: ABO AND RH		500 – 600
Laboratory	LAB00019	BUN		300 – 500
Laboratory	LAB00389	CA 125		2,000 – 2,500
Laboratory	LAB00075	CALCIUM, IONIZED		1,000 – 1,500
Laboratory	LAB00020	CALCIUM, TOTAL		500 – 600
Laboratory	LAB00021	CBC		500 – 600
Laboratory	LAB00477	CD68, NKTI		4,500 – 5,000
Laboratory	LAB00023	CHLORIDE		500 – 600
Laboratory	LAB00024	CHOLESTEROL, TOTAL		300 – 500
Laboratory	LAB00025	CK-MB		1,500 – 2,000
Laboratory	LAB00026	CLOTTING AND BLEEDING TIME		250 – 500
Laboratory	LAB00027	CLOTTING TIME		200 – 500
Laboratory	LAB00513	COMPREHENSIVE LEUKEMIA PANEL		42,500 – 43,000
Laboratory	LAB00350	CONFIRMATORY, DRUGTEST		1,300 – 1,500
Laboratory	LAB00275	COOMBS TEST		1,600 – 2,000
Laboratory	LAB00479	COVID 19 RAPID AB TEST		8,600 – 9,000
Laboratory	LAB00486	COVID 19 RAPID ANTIGEN TEST		600 – 800
Laboratory	LAB00465	COVID 19 RT-PCR, STAT FEE		600 – 800
Laboratory	LAB00484	COVID 19 RT-PCR, SUPER STAT FEE		1,200 – 1,500
Laboratory	LAB00467	COVID-19, IgG AB		2,600 – 3,000
Laboratory	LAB00466	COVID-19, TOTAL AB		2,600 – 3,000
Laboratory	LAB00029	CREATININE		500 – 700
Laboratory	LAB00527	CREATININE ANALYSIS, PERITONEAL FLUID (MMC) (S/O)		1,100 – 1,500
Laboratory	LAB00031	CROSS MATCHING		1,100 – 1,500
Laboratory	LAB00032	CRP, QUALITATIVE		400 – 500
Laboratory	LAB00033	CRP, QUANTITATIVE		1,900 – 2,000
Laboratory	LAB00262	CULTURE AND SENSITIVITY, BLOOD, ADULT		4,700 – 5,000
Laboratory	LAB00017	CULTURE AND SENSITIVITY, BLOOD, PEDIA		4,500 – 5,000
Laboratory	LAB00091	CULTURE AND SENSITIVITY, EXUDATES		3,700 – 4,000
Laboratory	LAB00037	CULTURE AND SENSITIVITY, RESPIRATORY		3,700 – 4,000
Laboratory	LAB00225	CULTURE AND SENSITIVITY, STOOL		3,400 – 4,000
Laboratory	LAB00250	CULTURE AND SENSITIVITY, URINE		3,600 – 4,000
Laboratory	LAB00489	CYSTATIN C (W/ EGFR)		3,300 – 4,000
Laboratory	LAB00476	CYTOKERATIN, NKTI		4,200 – 4,500
Laboratory	LAB00420	CYTOLOGY, CELLBLOCK		2,500 – 3,000
Laboratory	LAB00060	CYTOLOGY, PROCESSING FEE		700 – 1,000
Laboratory	LAB00061	CYTOLOGY, SMEAR & CELLBLOCK		2,500 – 3,000
Laboratory	LAB00056	CYTOLOGY, SMEAR, 1-4 SLIDES		1,300 – 1,500
Laboratory	LAB00449	D-DIMER, POCT		2,000 – 2,500
Laboratory	LAB00035	DENGUE BLOT		2,000 – 2,500
Laboratory	LAB00322	DRUGTEST		300- 500
Laboratory	LAB00410	ENVIRONMENTAL SWABBING		600 – 800
Laboratory	LAB00036	ESR		200 – 500
Laboratory	LAB00039	FBS		300 – 500
Laboratory	LAB00040	FECALYSIS		200 – 300
Laboratory	LAB00468	FERRITIN, ECI		1,200 – 1,500
Laboratory	LAB00167	FNAB PROCESSING FEE		500 – 700
Laboratory	LAB00168	FNAB PROFESSIONAL FEE		2,000 – 2,500
Laboratory	LAB00041	FT3		1,300 – 1,500
Laboratory	LAB00042	FT4		1,300 – 1,500
Laboratory	LAB00334	FWB, RH NEGATIVE		6,000 – 6,500
Laboratory	LAB00044	GLUCOSE JUICE ONLY		300 – 500
Laboratory	LAB00047	GRAM STAIN		300 – 500
Laboratory	LAB00261	H.PYLORI TEST, OR		400 – 600
Laboratory	LAB00048	H.PYLORI, QUALITATIVE		600 – 800
Laboratory	LAB00049	HBA1C		1,500 – 2,000
Laboratory	LAB00390	HBeAg		1,200 – 1,500
Laboratory	LAB00051	HBSAG, QUALITATIVE		400 – 600
Laboratory	LAB00052	HBSAG, QUANTITATIVE		800 – 1,000
Laboratory	LAB00391	HCG		1,300 – 1,500
Laboratory	LAB00196	HCV		1,000- 1,500
Laboratory	LAB00055	HISTOPATH A. CONFIRMATORY BIOPSIES, AND OTHER SINGLE, SMALL AND MEDIUM-SIZED SPECIMENS		1,000- 1,500
Laboratory	LAB00057	HISTOPATH B. SMALL AND MED-SIZED DIAG. BIOPSIES(INSICION,EXCISION,PUNCH,CORE NEEDLE,CURETTI)		1,000- 1,500
Laboratory	LAB00058	HISTOPATH C.MEDIUM-SIZED RESECTION SPECIMENS/LARGE SPECIMENS/2-3 SMALL SPECIMENS		2,000 – 2,500
Laboratory	LAB00059	HISTOPATH D.LARGE(RADICAL RESECTION SPECIMENS/2 LARGE SPECIMENS/4 OR MORE SMALL SPECIMES)		2,000 – 2,500
Laboratory	LAB00062	HISTOPATH ER PR		2,000 – 2,500
Laboratory	LAB00063	HISTOPATH ER PR PROCESSING FEE		8,900 – 9,900
Laboratory	LAB00064	HISTOPATH ERPR HER2 PACKAGE		13,000 – 14,000
Laboratory	LAB00065	HISTOPATH F SPECIAL STAINS/ SLIDE REVIEW		900 – 1,200
Laboratory	LAB00066	HISTOPATH G. SLIDE REVIEW		900 – 1,200
Laboratory	LAB00067	HISTOPATH H FROZEN SECTION		4,900 – 5,000
Laboratory	LAB00068	HISTOPATH HER 2		11,000 – 12,00
Laboratory	LAB00069	HISTOPATH I CT/UTZ GUIDED ASPIRATION BIOPSY		3,500 – 4,000
Laboratory	LAB00070	HISTOPATH J. EXTRA LARGE RESECTION		4,000 – 4,500
Laboratory	LAB00071	HISTOPATH PROCESSING FEE, EXTRA LARGE		1,300 – 1,500
Laboratory	LAB00072	HISTOPATH PROCESSING FEE, LARGE		700 – 800
Laboratory	LAB00073	HISTOPATH PROCESSING FEE, MEDIUM		400 – 600
Laboratory	LAB00074	HISTOPATH PROCESSING FEE, SMALL		300 – 500
Laboratory	LAB00538	HIV 1 VIRAL LOAD, HP		10,500 – 11,000
Laboratory	LAB00185	HUMAN FERRITIN		2,000 – 2,500
Laboratory	LAB00539	IMMUNOGLOBULIN A/IgA		3,400 – 4,000
Laboratory	LAB00540	IMMUNOGLOBULIN G/IgG		3,400 – 4,000
Laboratory	LAB00541	IMMUNOGLOBULIN M/IgM		3,400 – 4,000
Laboratory	LAB00474	IMMUNOHISTOCHEMICAL STAIN, S100, NKTI		4,000 – 4,500
Laboratory	LAB00295	INDIA INK		300 – 500
Laboratory	LAB00172	KATO KATZ		400 – 600
Laboratory	LAB00076	KOH MOUNT		200 – 500
Laboratory	LAB00478	LAT (MAT), HP		1,500 – 2,000
Laboratory	LAB00077	LDH		500 – 700
Laboratory	LAB00504	L-FABP		2,500 – 3,000
Laboratory	LAB00078	LIPASE		800 – 1,000
Laboratory	LAB00079	LIPID PROFILE		1,700 – 2,000
Laboratory	LAB00080	LIVER PROFILE		2,700 – 3,000
Laboratory	LAB00190	LUTEINIZING HORMONE		1,300 – 1,500
Laboratory	LAB00542	LYMPHOCYTE SUBSET ENUMERATION		10,500 – 11,000
Laboratory	LAB00081	MAGNESIUM		500 – 700
Laboratory	LAB00082	MALARIAL SMEAR		300 – 500
Laboratory	LAB00083	MICRAL TEST		600 – 800
Laboratory	LAB00377	MMC		9,000 – 9,300
Laboratory	LAB00314	MODIFIED AFB, STOOL		200 – 400
Laboratory	LAB00084	OCCULT BLOOD		200 – 400
Laboratory	LAB00043	OGCT, 50 GRAMS		600 – 800
Laboratory	LAB00045	OGTT, 100 GRAMS		1,300 – 1,500
Laboratory	LAB00046	OGTT, 75 GRAMS		1,000 – 1,200
Laboratory	LAB00088	PACKAGE, LIVER PROFILE		1,300 – 1,500
Laboratory	LAB00269	PAPSMEAR		400 – 600
Laboratory	LAB00090	PAPSMEAR PROCESSING FEE (APE)		300 – 500
Laboratory	LAB00092	PBS		400 – 600
Laboratory	LAB00093	PHOSPHORUS		400 – 600
Laboratory	LAB00302	PLATELET APHERESIS		22,500 – 22,800
Laboratory	LAB00522	PNEUMONIA PANEL, DETOXICARE		20,600 – 20,800
Laboratory	LAB00096	POTASSIUM		400 – 600
Laboratory	LAB00263	PPBS, 1HR		300 -600
Laboratory	LAB00001	PPBS, 2HR		300 – 500
Laboratory	LAB00097	PREGNANCY TEST		500- 700
Laboratory	LAB0475	PRIMARY IMMUNODEF. PANEL 3, HP		15,800 – 16,000
Laboratory	LAB00126	PROCALCITONIN, POCT		2,700 – 3,000
Laboratory	LAB00509	PROMO – BUN		300 -500
Laboratory	LAB00505	PROMO – CBC		300 – 500
Laboratory	LAB00510	PROMO – CREATININE		300 -500
Laboratory	LAB00506	PROMO – FBS		300 – 500
Laboratory	LAB00508	PROMO – HBA1C		1,300 – 1,500
Laboratory	LAB00507	PROMO – LIPID PROFILE DEACTIVATED		1,500 – 2,000
Laboratory	LAB00512	PROMO – SGOT/AST		300 – 500
Laboratory	LAB00511	PROMO – SGPT/ALT		300 -500
Laboratory	LAB00227	PROTEIN, TOTAL		500 – 700
Laboratory	LAB00254	PROTEIN, URINE, 24 HRS.		500 – 700
Laboratory	LAB00098	PROTIME		500 – 700
Laboratory	LAB00099	PSA		2,100 -2,300
Laboratory	LAB00537	RAPID ANTIGEN TEST (FREE)
Laboratory	LAB00100	RBS		300 – 500
Laboratory	LAB00521	RESPIRATORY PANEL, DETOXICARE		13,300 – 13,500
Laboratory	LAB00101	RETIC COUNT		300 – 500
Laboratory	LAB0474	RETICULIN STAINING, ST. LUKES		10,000 – 10,500
Laboratory	LAB00475	RETICULIN, NKTI		2,500 – 2,700
Laboratory	LAB00102	RHEMATOID FACTOR, QUANTITATIVE		1,000 – 1,500
Laboratory	LAB00103	RHEUMATOID FACTOR, QUALITATIVE		300 – 500
Laboratory	LAB00299	RPR, QUANTITATIVE		800 – 1,000
Laboratory	LAB00104	RPR/VDRL, QUALITATIVE		300 – 500
Laboratory	LAB00267	SALMONELLA TEST, QUALITATIVE		1,100 – 1,500
Laboratory	LAB00316	SCOTCH TAPE METHOD		300- 500
Laboratory	LAB00105	SEMENALYSIS		500 – 600
Laboratory	LAB00303	SERUM TRANFERRIN		7,500 – 7,700
Laboratory	LAB00220	SGOT/AST		500 – 700
Laboratory	LAB00221	SGPT/ALT		500 – 700
Laboratory	LAB00222	SODIUM		500 – 700
Laboratory	LAB00223	SODIUM (BLOOD CHEMISTRY)		500 – 700
Laboratory	LAB00363	T3		1,000 – 1,200
Laboratory	LAB00364	T4		1,000 – 1,200
Laboratory	LAB00452	TB LAMP		3,600 – 3,800
Laboratory	LAB00392	TESTOSTERONE		2,600 – 3,000
Laboratory	LAB00231	THERAPEUTIC PHLEBOTOMY FEE		600 – 800
Laboratory	LAB00195	THROMBOPLASTIN		300 – 500
Laboratory	LAB00206	THYROGLOBULIN		2,100 – 2,300
Laboratory	LAB00233	TMG SMEAR		500 – 600
Laboratory	LAB00234	TOURNIQUET TEST		200 – 300
Laboratory	LAB00235	TOXIC GRANULATION		300 – 500
Laboratory	LAB00236	TPAG		500 – 700
Laboratory	LAB00237	TPSA		1,700 – 2,000
Laboratory	LAB00238	TRIGLYCERIDE		500 – 700
Laboratory	LAB00239	TROPONIN I, QUALITATIVE		900 – 1,000
Laboratory	LAB00240	TROPONIN I, QUANTITATIVE		2,200 – 2,500
Laboratory	LAB00268	TSH		1,200 – 1,500
Laboratory	LAB00244	TZANCK SMEAR		500 – 700
Laboratory	LAB00245	URIC ACID		300 – 500
Laboratory	LAB00259	URINALYSIS		150 – 300
Laboratory	LAB00216	VARICELLA IGG		7,200 – 8,000
Laboratory	LAB00183	VCT		800 – 1,000
Laboratory	LAB00482	VTM		500 – 700
Rehab Rates	REH00011	OT TREATMENT		1,000 – 1,200
Rehab Rates	REH00012	OT, EATING AND SWALLOWING MANAGEMENT/PRE SPEECH TRAINING/		1,000 – 1,200
Rehab Rates	REH00001	PT TREATMENT		800 – 1,000
Rehab Rates	REH00002	PT, COLD PACKS		50 – 150
Rehab Rates	REH00059	PT, DRY NEEDLING		600 – 800
Rehab Rates	REH00003	PT, ES/TENS		50 – 150
Rehab Rates	REH00066	PT, HI-LASER		500 – 700
Rehab Rates	REH00050	PT, HMO		1,100 – 1,200
Rehab Rates	REH00004	PT, HOTPACK		70 – 150
Rehab Rates	REH00005	PT, INFRARED RAY		70 – 150
Rehab Rates	REH00061	PT, INPATIENT WELLNESS		300 – 500
Rehab Rates	REH00051	PT, LASER		200 – 500
Rehab Rates	REH00006	PT, PARAFFIN WAX BATH		70 – 150
Rehab Rates	REH00052	PT, PROPRIOCEPTIVE NEURO REHAB		1,400 – 1,500
Rehab Rates	REH00053	PT, RENAL		200 – 500
Rehab Rates	REH00007	PT, STATIONARY BIKE		70 – 150
Rehab Rates	REH00010	PT, ULTRASOUND		70 – 150
Rehab Rates	REH00055	PT, VTE		300 – 500
Ultrasound	UTZ00007	ABDOMINAL AORTA		1,200 – 1,500
Ultrasound	UTZ00008	ABDOMINAL WALL		1,300 – 1,500
Ultrasound	UTZ00052	BIOPSY		15,100 – 15,500
Ultrasound	UTZ00013	BREAST ULTRASOUND		1,700 – 1,900
Ultrasound	UTZ00015	CHEST		1,400 – 1,600
Ultrasound	UTZ00016	CHEST MAPPING (BILATERAL)		2,400 – 2,600
Ultrasound	UTZ00017	CHEST MAPPING (UNILATERAL)		1,600 – 1,800
Ultrasound	UTZ00020	CRANIAL		2,200 – 2,500
Ultrasound	UTZ00021	FIVE ORGANS		2,200 – 2,500
Ultrasound	UTZ00022	FLANK MASS		1,400 – 1,800
Ultrasound	UTZ00023	FOUR ORGANS		2,100 – 2,500
Ultrasound	UTZ00024	FREE FLUID		3,300 – 4,000
Ultrasound	UTZ00025	GALLBLADDER		1,300 – 1,500
Ultrasound	UTZ00028	HBT (LIVER AND GALLBLADDER)		1,900 – 2,200
Ultrasound	UTZ00033	HBT PANCREAS, KUB		2,200 – 2,500
Ultrasound	UTZ00029	HBT, KIDNEYS		1,800 – 2,000
Ultrasound	UTZ00030	HBT, PANCREAS		2,200 – 2,500
Ultrasound	UTZ00031	HBT, PANCREAS, KIDNEYS		2,300 – 2,500
Ultrasound	UTZ00034	HBT, PANCREAS, KUB, PELVIC		2,700 – 3,000
Ultrasound	UTZ00035	HBT, PANCREAS, KUB, PROSTATE GLAND		2,700 – 3,000
Ultrasound	UTZ00032	HBT, PANCREAS, SPLEEN		2,300 – 2,500
Ultrasound	UTZ00036	HBT, PANCREAS, SPLEEN, KIDNEYS		2,300 – 2,500
Ultrasound	UTZ00037	HBT, SPLEEN		1,900 – 2,200
Ultrasound	UTZ00038	INGUINAL		1,600 – 1,800
Ultrasound	UTZ00039	INGUINO SCROTAL		2,100 – 2,500
Ultrasound	UTZ00040	INGUINO SCROTAL WITH DOPPLER		2,700 – 3,000
Ultrasound	UTZ00041	KIDNEYS		1,400 – 1,800
Ultrasound	UTZ00042	KUB		2,100 – 2,500
Ultrasound	UTZ00043	KUB, PELVIC		3,000 – 3,200
Ultrasound	UTZ00044	KUB, PROSTATE		2,200 – 2,500
Ultrasound	UTZ00045	LIVER		1,300 – 1,500
Ultrasound	UTZ00046	LIVER, KIDNEYS		1,700 – 2,200
Ultrasound	UTZ00047	LOWER ABDOMEN (W/ KIDNEYS)		2,000 – 2,200
Ultrasound	UTZ00048	MUSCULOSKELETAL		3,500 – 3,700
Ultrasound	UTZ00049	NECK (ANTERIOR)		2,200 – 2,500
Ultrasound	UTZ00081	NECK WITH DOPPLER		2,700 – 3,000
Ultrasound	UTZ00050	ONE ORGAN		1,400 – 1,800
Ultrasound	UTZ00051	PANCREAS		1,200 – 1,500
Ultrasound	UTZ00053	PARACENTESIS		15,000 – 15,400
Ultrasound	UTZ00083	PROMO – KUB		1,700 – 2,000
Ultrasound	UTZ00059	PROSTATE		1,400 – 1,700
Ultrasound	UTZ00060	SCROTAL		1,400 – 1,700
Ultrasound	UTZ00061	SCROTAL WITH DOPPLER		2,100 – 2,300
Ultrasound	UTZ00062	SIX ORGANS		2,700 – 3,000
Ultrasound	UTZ00082	SMALL PARTS		1,500 – 1,700
Ultrasound	UTZ00063	THORACENTESIS		16,000 – 16,300
Ultrasound	UTZ00064	THREE ORGANS		1,800 – 2,000
Ultrasound	UTZ00065	THYROID GLAND		1,500 – 1,800
Ultrasound	UTZ00066	THYROID WITH DOPPLER		2,100 – 2,500
Ultrasound	UTZ00068	TRANSRECTAL PROSTATE		1,800 – 2,000
Ultrasound	UTZ00073	TWO ORGANS		1,600 – 1,800
Ultrasound	UTZ00080	ULTRASOUND-GUIDED BIOPSY		6,200 – 6,500
Ultrasound	UTZ00026	ULTRASOUND-GUIDED PARACENTESIS		6,100 – 6,500
Ultrasound	UTZ00027	ULTRASOUND-GUIDED THORACENTESIS		6,200 – 6,500
Ultrasound	UTZ00074	UMBILICAL		1,500 – 2,000
Ultrasound	UTZ00075	UPPER ABDOMEN		2,800 – 3,000
Ultrasound	UTZ00076	URINARY BLADDER		1,300 – 1,500
Ultrasound	UTZ00077	URINARY BLADDER, PELVIC		1,800 – 2,000
Ultrasound	UTZ00078	URINARY BLADDER, PROSTATE		1,700 – 2,000
Ultrasound	UTZ00079	WHOLE ABDOMEN		3,300 – 3,500
Mammogram	MAM00001	DIGITAL MAMMOGRAM	3625	3,700 – 4,000
Mammogram	MAM00002	MAMMO CONE DOWN VIEW (SINGLE BREAST)	1370	1,300 – 1,500
CT-Scan	CTS00075	3D RECONSTRUCTION	420	400 – 500
CT-Scan	CTS00001	ABCESS DRAINAGE	18230	18,200 – 18,500
CT-Scan	CTS00002	ADRENALS PLAIN	8360	8,300 – 9,000
CT-Scan	CTS00003	ADRENALS WITH CONTRAST	10270	10,270 – 10,500
CT-Scan	CTS00004	ANKLE PLAIN	6980	6,900 – 7,200
CT-Scan	CTS00005	ANKLE WITH CONTRAST	9840	9,800 – 10,000
CT-Scan	CTS00006	ARM PLAIN	7720	7,700 – 8,000
CT-Scan	CTS00007	ARM WITH CONTRAST	8960	9,000 -9,300
CT-Scan	CTS00009	CERVICAL SPINE PLAIN	7500	7,500 – 7,800
CT-Scan	CTS00010	CERVICAL SPINE WITH CONTRAST	10090	10,100 – 10,500
CT-Scan	CTS00011	CHEST PLAIN	7833	7,800 – 8,000
CT-Scan	CTS00012	CHEST WITH CONTRAST	8575	8,500 – 8,800
CT-Scan	CTS00074	CT-ANGIO HEAD	3630	3,600 – 3800
CT-Scan	CTS00008	CT-GUIDED BIOPSY	17070	17,100 – 17,500
CT-Scan	CTS00013	FACIAL BONE PLAIN	12031	12,100 – 12,500
CT-Scan	CTS00014	FACIAL BONE WITH CONTRAST	12750	12,700 – 12,800
CT-Scan	CTS00015	FOOT PLAIN	7720	7,700 – 7,800
CT-Scan	CTS00016	FOOT WITH CONTRAST	8830	8,800 – 9,000
CT-Scan	CTS00017	FOREARM PLAIN	7720	7,700 – 8,000
CT-Scan	CTS00018	FOREARM WITH CONTRAST	8830	8,800 – 9,200
CT-Scan	CTS00019	HAND PLAIN	7270	7,300 – 8,000
CT-Scan	CTS00020	HAND WITH CONTRAST	8370	8,300 – 9,000
CT-Scan	CTS00023	HEAD (W/ BONE WINDOW) PLAIN	7250	7,200 – 7,500
CT-Scan	CTS00022	HEAD (W/ BONE WINDOW) WITH CONTRAST	6850	6,800 – 7,000
CT-Scan	CTS00021	HEAD PLAIN	6975	6,800 – 7,000
CT-Scan	CTS00024	HEAD WITH CONTRAST	7110	7,200 – 7,500
CT-Scan	CTS00071	HIGH RESOLUTION CT (HRCT)	11760	11,700 – 12,000
CT-Scan	CTS00025	HIP JOINT PLAIN	7270	7,300 – 8,000
CT-Scan	CTS00026	HIP JOINT WITH CONTRAST	8510	8,500 – 9,000
CT-Scan	CTS00027	KNEE PLAIN	8250	8,300 – 8,500
CT-Scan	CTS00028	KNEE WITH CONTRAST	9840	9,800 – 10,000
CT-Scan	CTS00029	LEG PLAIN	8900	8,900 – 9,100
CT-Scan	CTS00030	LEG WITH CONTRAST	9580	9,500 – 9,800
CT-Scan	CTS00033	LOWER ABDOMEN (W/ KIDNEYS) PLAIN	8470	8,400 – 8,700
CT-Scan	CTS00031	LOWER ABDOMEN (W/ KIDNEYS) WITH CONTRAST	9420	9,400 – 10,000
CT-Scan	CTS00032	LOWER ABDOMEN PLAIN	7650	7,600 – 7,800
CT-Scan	CTS00034	LOWER ABDOMEN WITH CONTRAST	10270	10,300 – 10,500
CT-Scan	CTS00070	LOWER EXTREMITIES	7740	7,700 – 8,000
CT-Scan	CTS00035	LUMBAR SPINE PLAIN	7470	7,700 – 8,000
CT-Scan	CTS00036	LUMBAR SPINE WITH CONTRAST	10830	10,800 – 11,000
CT-Scan	CTS00037	MANDIBLE PLAIN	11350	11,300 – 11,500
CT-Scan	CTS00038	MANDIBLE WITH CONTRAST	12670	12,600 – 12,800
CT-Scan	CTS00039	MASTOIDS PLAIN	11490	11,500 – 11,800
CT-Scan	CTS00040	MASTOIDS WITH CONTRAST	12150	12,100 – 12,800
CT-Scan	CTS00041	NASOPHARYNX PLAIN	11100	11,200 – 11,500
CT-Scan	CTS00042	NASOPHARYNX WITH CONTRAST	11710	11,700 – 12,000
CT-Scan	CTS00043	NECK PLAIN	11350	11,300 – 11,500
CT-Scan	CTS00044	NECK WITH CONTRAST	12330	12,300 – 12,500
CT-Scan	CTS00045	ORBITAL PLAIN	11100	11,100 – 11,500
CT-Scan	CTS00046	ORBITAL WITH CONTRAST	12320	12,300 – 12,500
CT-Scan	CTS00047	OROPHARYNX PLAIN	10940	10,900 – 11,100
CT-Scan	CTS00048	OROPHARYNX WITH CONTRAST	11680	11,600 – 11,800
CT-Scan	CTS00049	PARANASAL SINUSES PLAIN	11883	11,800 – 12,000
CT-Scan	CTS00050	PARANASAL SINUSES WITH CONTRAST	11710	11,700 – 12,000
CT-Scan	CTS00051	PITUITARY PLAIN	10090	10,100 – 10,500
CT-Scan	CTS00052	PITUITARY WITH CONTRAST	11710	11,700 – 12,000
CT-Scan	CTS00053	SCREENING SINUS (CANAL)	11210	11,200 – 11,500
CT-Scan	CTS00054	SHOULDER PLAIN	8700	8,700 – 9,000
CT-Scan	CTS00055	SHOULDER WITH CONTRAST	11800	11,800 – 12,000
CT-Scan	CTS00056	STONOGRAM PLAIN	10452	10,500 – 10,700
CT-Scan	CTS00057	STONOGRAM WITH CONTRAST	11110	11,100 – 11,500
CT-Scan	CTS00058	TEMPORAL BONE / (INTERNAL AUDITORY CANAL)	11620	11,600 – 12,000
CT-Scan	CTS00059	TEMPORAL BONE / IAC WITH CONTRAST	12670	12,700 – 13,000
CT-Scan	CTS00060	THIGH PLAIN	10400	10,400 – 10,700
CT-Scan	CTS00061	THIGH WITH CONTRAST	9980	9,900 – 10,000
CT-Scan	CTS00062	THORACIC SPINE PLAIN	8490	8,500 – 9,000
CT-Scan	CTS00063	THORACIC SPINE WITH CONTRAST	11620	11,700 – 12,000
CT-Scan	CTS00064	UPPER ABDOMEN PLAIN	9360	9,300 – 9,500
CT-Scan	CTS00065	UPPER ABDOMEN WITH CONTRAST	10540	10,500 – 10,700
CT-Scan	CTS00072	UPPER EXTREMITIES	5930	5,900 – 6,100
CT-Scan	CTS00066	WHOLE ABDOMEN PLAIN	15211	15,300 – 15,800
CT-Scan	CTS00067	WHOLE ABDOMEN WITH CONTRAST	15953	15,900 – 16,100
CT-Scan	CTS00068	WRIST PLAIN	7270	7,300 – 8,000
CT-Scan	CTS00069	WRIST WITH CONTRAST	8370	8,300 – 8,500
Cardio	CVU00028	24 HOUR AMBULATORY BP MONITORING	5236	5,200 – 5,500
Cardio	CVU00001	2D ECHO	3870	3,800 – 4,000
Cardio	CVU00003	2D ECHO WITH DOPPLER STUDY	4810	4,800 – 5,000
Cardio	CVU00004	2D ECHO WITH DOPPLER STUDY, PEDIA	4810	4,800 – 5,000
Cardio	CVU00002	2D ECHO, PEDIA	3870	3,800 – 5,000
Cardio	CVU00032	2D ECHOCARDIOGRAM PLAIN WITH GLS	4210	4,200 – 5,000
Cardio	CVU00033	2D ECHOCARDIOGRAM WITH DOPPLER STUDY WITH GLS	5150	5,100 – 5,300
Cardio	CVU00020	ANKLE-BRACHIAL INDEX	1120	1,120 – 1,500
Cardio	CVU00005	ARTERIAL AND VENOUS DUPLEX SCAN-LOWER EXTREMITIES	17830	17,800 – 18,000
Cardio	CVU00021	ARTERIAL AND VENOUS DUPLEX SCAN-UPPER EXTREMITIES	16140	16,000 – 16,300
Cardio	CVU00006	ARTERIAL DUPLEX SCAN-LOWER EXTREMITIES	10208	10,200 – 10,500
Cardio	CVU00022	ARTERIAL DUPLEX SCAN-UPPER EXTREMITIES	8220	8,200 – 8,500
Cardio	CVU00007	BUBBLE CONTRAST	2320	2,300 – 2,500
Cardio	CVU00008	CAROTID DUPLEX SCAN	7908	7,900 – 8,000
Cardio	CVU00009	DUPLEX SCAN OF ABDOMINAL AORTA	9160	9,100 – 9,500
Cardio	CVU00010	DUPLEX SCAN OF AV FISTULA/GRAFT	5640	5,600 – 5,800
Cardio	CVU00011	ELECTROCARDIOGRAM	500	500 – 700
Cardio	CVU00013	HOLTER MONITORING 24 HOURS	5925	5,900 – 6,100
Cardio	CVU00014	HOLTER MONITORING 48 HOURS	8220	8,200 – 8,500
Cardio	CVU00015	RENAL DUPLEX SCAN	9160	9,100 – 9,300
Cardio	CVU00016	TRANSCRANIAL DUPLEX SCAN	9310	9,300 – 9,500
Cardio	CVU00017	TREADMILL STRESS TEST	3138	3,100 – 3,300
Cardio	CVU00018	VENOUS COMPRESSION-LOWER EXTREMITIES	4190	4,100 – 4,300
Cardio	CVU00023	VENOUS COMPRESSION-UPPER EXTREMITIES	4190	4,100 – 4,300
Cardio	CVU00019	VENOUS DUPLEX SCAN-LOWER EXTREMITIES	10208	10,300 – 10,500
Cardio	CVU00024	VENOUS DUPLEX SCAN-UPPER EXTREMITIES	8220	8,200 – 8,500