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     TONDO MEDICAL CENTER

                   LABORATORY FEES 2011
     Laboratory Tests
                    CLINICAL CHEMISTRY    Lab.Fees
 1   ABG                                     750.00
 2   Alkaline Phosphate                      110.00
 3   Amylase                                 140.00
 4   Bilirubin,Total & Direct                130.00
 5   Blood Urea nitrogen                       80.00
 6   Total Cholesterol                         90.00
 7   Direct HDL cholesterol                  250.00
 8   Creatinine                                80.00
 9   Glucose                                   80.00
10   SGOT                                    110.00
11   SGPT                                    110.00
12   SLDH                                    110.00
13   Total protein                             85.00
14   Serum Albumin                             85.00
15   Triglycerides                           110.00
16   Uric Acid                                 80.00
17   Total Calcium                           100.00
18   Magnesium                               200.00
19   Phosphorus                              120.00
20   Electrolytes:Na,K,Cl                    250.00
21   HBA1c                                   420.00
22   Lipid profile                           450.00
23   OGCT w/glucose solution                 260.00
24   OGTTw/glucose solution                  420.00
25   2hr. PPBS                               260.00

                       HEMATOLOGY
 1   CBC                                     120.00
 2   Hgb & Hct                               100.00
 3   Platelet only                           100.00
 4   Perpheral smear                         120.00
 5   WBC w/diff count                         95.00
 6   RBC count only                           95.00
 7   WBC count only                           95.00
 8   Diff.count w/toxic granules             100.00
 9   ESR                                      60.00
10   CT and BT                                60.00
11   Clotting time only                       50.00
12   Malarial smear                          130.00
13   Hemoglubin for blood donors              95.00
14   PT                                      200.00
15 PTT                                        250.00

         SEROLOGY/IMMUNOLOGY/BLOOD BANK
 1   ABO w/Rh                                   90.00
 2   ASO qualitative                           150.00
 3   ASO titer                                 350.00
 4   Beta HCG                                  500.00
 5   CRP qualitative                           150.00
 6   CRP w/titer                               350.00
 7   Coombs test                               200.00
 8   Compatibility testing (x-match)           300.00
 9   Dengue NS1 antigen                      1,300.00
10   RPR                                        90.00
11   Anti HAV IgM                              500.00
12   HBSAg                                     260.00
13   HCV                                       470.00
14   HIV 1&2                                   300.00
15   Blood screening per unit                1,500.00
16   FT4                                       360.00
17   TSH                                       460.00
18   PSA (total)                               900.00
19   Samonella Typhi                           600.00
20   Troponin I                                750.00
                    CLINICAL MICROSCOPY
 1   Rt. Urinalysis                            60.00
 2   Urine Urobilinogen/ Bilirubin/Ketones     60.00
 3   Urine Glucose or Albumin                  50.00
 4   Rt. Fecalysis                             50.00
 5   smear for Amoeba                          60.00
 6   Fecal Occult Blood                       100.00
 7   Seminal Fluid                            100.00
 8   Pregnancy test                           120.00

                      MISCELLANEOUS
 1   AFB staining                              75.00
 2   Gram Staining                             75.00
 3   Pap smear                                120.00
 4   Drug test                                180.00
 5   FNAB                                     200.00
 6   Frozen section                           750.00
 7   Phlebotomy                                40.00
 8   Blood bag                                105.00

               RADIOLOGY DEPARTMENT
                       X-RAY
 1   SKULL                                    230.00
 2   NASAL BONE                               220.00
 3   ORBITS                                   256.00
 4   MAXILLA                                  238.00
 5   MASTOIDS                                 250.00
 6   PARANASAL SINUSES                            312.00
 7   FACIAL BONES                                 174.00
 8   TEMPORO-MANDIBULAR JOINT                     288.00
 9   MANDIBLE                                     238.00
10   OPTICS                                       295.00
11   CERVICAL                                     256.00
12   CERVICAL SPINE (3VIEWS)                      280.00
13   NECK                                         144.00
14   NASOPHARYNX                                  240.00
15   CLAVICLE                                      90.00
16   SHOULDER (1VIEW)                              90.00
17   SHOULDER (2VIEWS)                            180.00
18   CHEST (PEDIA)                                240.00
19   CHEST (ADULT)                                140.00
20   CERVICO-THORACIC                             156.00
21   THORACIC CAGE                                120.00
22   THORACIC SPINE (THORACO-LUMBAR)              240.00
23   PLAIN ABDOMEN (PEDIA-UPRIGHT/SUPINE/TRANSLAT)180.00
24   PLAIN ABDOMEN (ADULT-UPRIGHT/SUPINE)         240.00
25   KUB/PELVIS                                   120.00
26   LUMBAR VERTEBRA                              240.00
27   LUMBO-SACRAL                                 240.00
28   DORSAL VERTEBRA                              240.00
29   HUMERUS/ARM                                  200.00
30   FOREARM                                      156.00
31   THIGH/LEG (AP/L)                             204.00
32   ELBOW/WRIST/HAND/KNEE/ANKLE/FOOT             102.00
33   SKELETAL SURVEY                            3,356.00

                   SPECIAL PROCEDURES
 1   Cardiac series                               270.00
 2   Sialography                                  264.00
 3   Barium swallow                               276.00
 4   Upper Gastro intestinal series (UGIS)        470.00
 5   Hypotonic duodenography                      228.00
 6   Barium enema                                 629.00
 7   Oral cholecystography                        228.00
 8   Operative cholangiography                    352.00
 9   Chole GI series                              612.00
10   T-tube cholangiography                       352.00
11   Small intestinal series                      276.00
12   Colonogram                                   280.00
13   Intra-venous pyelography (IVP)               632.00
14   Fistulogram                                  240.00
15   Hystero-salphingography                      254.00

                 ULTRASOUND
 1 CRANIAL                                        264.00
 2 THYROID                                        264.00
 3 THORAX CC GIUDED UTZ                           764.00
 4   HEMITHORAX (right/left)                 215.00
 5   HBT (liver,pancreas, GB, slpeen, CBD)   264.00
 6   KUB/RENAL                               504.00
 7   BREAST (one)                            264.00
     BREAST (bilatral)                       528.00
 8   PELVIC (1-3mos)                         216.00
 9   PELVIC (4-9mos)                         216.00
10   FETAL BIOMETRY                          264.00
11   BPS/BIOPHYSICAL SCORING                 264.00
12   WHOLE ABDOMEN                           768.00
13   TRANSVAGINAL                            254.00
14   PROSTATE                                216.00
15   INGUINO-SCROTAL                         254.00
16   EXTREMITIES                             216.00
17   FAST                                    216.00

				
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