Radiographic Examinations
| Chest PA | 140.00 |
| Chest PA & Lat (Adult) | 280.00 |
| Chest PA & Lat (Pedia) | 224.00 |
| Chest Lateral View or Decubitus | 140.00 |
| Apicolordotic View | 126.00 |
| Rib Cage (Thoracic Cage) AP/2 Obliques | 420.00 |
| Skull (AP/Lat) | 224.00 |
| Skull Series (AP/Lat/Townes) | 364.00 |
| Paranasal Sinuses (Caldwell Waters/ Lateral) | 364.00 |
| Waters View Only | 140.00 |
| Townes View Only | 140.00 |
| Mastoids (Laws/Townes/Stenvers) | 336.00 |
| Mandible (AP/Oblique) | 336.00 |
| Nasal Bone (2 Lateral low kv - soft tissue tech.) | 140.00 |
| Orbits (Caldwell/2 Oblique) | 336.00 |
| Temporomandibular joints (close/open mounth) | 378.00 |
| Submentovertex View | 196.00 |
| Cervical Spine (AP/LAT/Oblique) | 308.00 |
| Thoracic Spine (AP & Lat) | 287.00 |
| Lumbrosacral Spine (AP/Lat) | 287.00 |
| Lumbrosacral Spine (AP/Lat/Oblique) | 350.00 |
| Sacrum (AP/Lat) | 203.00 |
| Skeletal Survey | 4,200.00 |
| Babygram | 140.00 |
| Neck (Low KVAP/LAT) | 203.00 |
| Shoulder Joint (AP/neutral/external & internal rotation) | 434.00 |
| Forearm or Arm (AP/LAT) | 203.00 |
| Elbow or Wrist joint (AP/LAT) | 203.00 |
| Hand (AP/Oblique) | 203.00 |
| Finger - One digit (AP & LAT) | 119.00 |
| Hip Joints (AP/Neutral/Frog Leg Position) | 238.00 |
| Pelvis (AP) | 140.00 |
| Thigh or Leg (AP/LAT) | 238.00 |
| Knee or ankle joint (AP/LAT) | 140.00 |
| Foot (AP/LAT/Oblique) | 210.00 |
| Scoliosis Series (AP Neutral & Bilateral Bending) | 434.00 |
| Flat Plate or Abdomen (AP Spine & Upright) | 287.00 |
| Scout Film of Abdomen (AP Supine) | 140.00 |
| Invertogram (Rice Wangesteen) | 203.00 |
| KUB Film | 140.00 |
| Pelvimetry | 287.00 |
| IV Urogram, (Exclude Contrast) | 910.00 |
| Upper GI Series | 910.00 |
| Small Intestinal Series | 840.00 |
| UGIS with SIS | 1,400.00 |
| Barium Enema (Exclude Contrast) | 910.00 |
| Hysterosalphinography (Exclude Contrast) | 336.00 |
Ultrasound Examination
| Whole Abdomen (Upper Abdomen, Kidneys and Pelvic) | 1,050.00 |
| Upper Abdomen (Liver, Gallbladder, Pancreas, Spleen) | 560.00 |
|
Lower Abdomen (Kidneys UB (Uterus and Adnexae-female, Prostate Gland-male) |
840.00 |
| One Organ basis (single) | 280.00 |
| Pelvic (uterus and adnexae) | 350.00 |
| Kidneys | 350.00 |
| Urinary Bladder and Prostate | 350.00 |
| Upper Abdomen and Kidneys | 700.00 |
| Kidneys and Urinary Bladder | 560.00 |
| Pregnancy and Bioviability | 350.00 |
| Pregnancy and Biophysical Scoring | 490.00 |
| Transvaginal Ultrasound | 350.00 |
| Transrectal Ultrasound | 350.00 |
| Breast Ultrasound | 700.00 |
| Chest Ultrasound | 420.00 |
| Cranial Ultrasound | 700.00 |
| Scrotal | 560.00 |
| Soft Tissue | 420.00 |
Obstetric Ultrasound Examination (Biometry included to all)
| Regular OB Procedures | |
| Transvaginal Sonography (1st Trimester) | 250.00 |
| Transabdominal Ultrasound (2nd & 3rd Trimester) | 250.00 |
| Special OB Procedures | |
| Biophysical Profile Scoring | 490.00 |
| Congenital Anomaly Scanning | 500.00 |
| OB-Doppler (Doppler Velocimetry) | 500.00 |
| Placental Doppler | 500.00 |
| First Trimester Ultrasound Screening Markers | 500.00 |
| OB 3D/4D | 600.00 |
| Fetal Echo | 700.00 |
Gynecologic Ultrasound Examination
| Regular GYN Procedures | |
| Transabdominal Ultrasound | 350.00 |
| Transvaginal Ultrasound | 350.00 |
| Transrectal Ultrasound | 350.00 |
| Special GYN Procedures | |
| Follicle Monitoring (max. 3 scans per menstrual cycle) | 500.00 |
| GYNE Doppler | 500.00 |
| 3D GYNE | 500.00 |
| Saline Infusion Sonohysterography (SISH) | 600.00 |
| Hysterosonosalphingography | 600.00 |
* FOR ULTRASOUND, ADDITIONAL 50% SHALL BE CHARGED FOR EACH ADDITIONAL FETUS IF WITH MULTIPLE GESTATION
* FOR SALINE INFUSION SONOHYSTEROGRAPHY AND HYSTEROSONOSALPHINGOGRAPHY, THE PATIENT WILL PROVIDE/BUY ALL NECESSARY MATERIALS NEEDED.
