schedule of charges - narayana health

SCHEDULE OF CHARGES

w.e.f January 2022

Narayana Superspeciality Hospital, Gurugram

Narayana Superspeciality Hospital, Gurugram

Address: DLF Phase – III, Sector -24, Behind Ambience Mall, Gurugram

Nestled close to DLF Cyber City and the Delhi - Jaipur Highway, Narayana Superspeciality Hospital is a NABH accredited world-class medical facility catering to the healthcare needs of the NCR region. Featuring experienced medical professionals and the latest in medical infrastructure, the hospital represents Narayana Health’s commitment to quality medical care and patient service.

Narayana Superspeciality Hospital has been built from the ground-up to be a state-of-the-art facility; with expertly planned and well-equipped sections, including a spacious OPD area and comfortable patient rooms which allows the hospital to cater to both In-Patients and Out-Patients in equal measure.

The world-class medical equipment and infrastructure at the hospital ensures that it is capable of providing a wide range of treatment; from complex to routine, from paediatric to adult. The hospital’s location also conferrers on it several key advantages

• It is the closest superspeciality hospital from Indira Gandhi International Airport towards Gurugram.

• It has excellent connectivity via Metro and Highway to Gurugram and Delhi.

• It is the nearest superspeciality hospital from DLF Cyber City.

• It is close to major residential areas in Gurugram.

Centres of Excellence

Cardiac Sciences

NeurosciencesRenal SciencesGastro Sciences

OncologyOrthopaedics, Joint Replacement & Spine Surgery

Internal Medicine

Emergency & Critical Care

Liver Transplant | Kidney Transplant | Oncology – Medical, Radiation & Surgical | General Surgery | Internal Medicine

Nephrology | Urology | Diabetology | Rheumatology | Pulmonology | Emergency Medicine | ENT | Ophthalmology

Dermatology & Cosmetology | Paediatric Surgery | Vascular Surgeries | Endocrinology | Radiology | Clinical Nutrition

& Dietetics | Physiotherapy & Rehabilitation

Narayana

Super Speciality Hospital, Gurugram

Unit of Narayan Health

Schedule of Charges Jan 2022

NSH, Gurugram Schedule of Charges (Effective from 1st Jan 2022)

Schedule of Charges is Effective from 1st Jan 2022 till the next revision, any further addition / modification required will be done as on addendum/ amendments till the next revision.

DISCLAIMER

All the efforts have been made to ensure that there are no inconsistencies or typographical error in the schedule. Nevertheless, if any error is noted, it may please be brought to the notice of the billing in charge.


OPD Charges

1. Hospital Registration charge

Rs. 150/-

2. OPD consultation

a. All consultations are valid for 7 days (counted from the day of billing)

(Up to a maximum of 1 visit to the same consultant.)

b. Consultation Charges for all Specialties Services is Rs. 1200/-

IN PATIENT DEPARTMENT (IPD) CONSULTATION

SERVICE_NAME G Ward Semi Pvt Private Suite Dlx Suite CCA/ICU

CONSULTATION – IP 1400 1600 1800 2000 2200 1600 CROSS CONSULTATION – IP 1400 1600 1800 2000 2200 1600 CONSULTATION – PHYSIOTHERAPY 900 900 900 900 900 900 CONSULTATION- DIETITIAN 500 500 500 500 500 500

Only two IP consultation is applicable for primary consultant & second consultation will be charged after 4 PM.

If the patient admitted after 12 PM, only one visit to be charged for primary consultant. Only one Cross/referring consultation for different specialty will be charged.

ROOM CHARGES

Bed Type G Ward Semi Pvt Private Suite Dlx Suite CCA/ICU

BED CHARGES – WARD 4500 6500 10000 15000 16500 14500

BED CHARGES - DAY CARE 3200

BED CHARGES - DAY CARE - UPTO 3 HOURS 1400




BILLING GUIDELINES

BED CHARGES Charges shall be levied as per rates applicable.

The billing starts from the time of admission. Procedures, Surgeries, Packages & Doctor Visit, etc. shall be charged according to the respective room category opted for as mentioned. A stay beyond 8 hrs shall

attract full day room rent. 24 hrs billing cycle on room rent shall be applicable

BED TRANSFER In the event of a bed transfer during the course of treatment, the higher category bed charges shall be applicable from the day of transfer.

Overnight stay shall be charge as per higher room category.

ADMISSION DIRECTLY INTO CRITICAL CARE

In case patient is admitted to Critical Care bed directly, the charges for procedure/surgeries shall be as per the charges applicable to the semi-private room.

CONSULTATION

One follow-up OPD consultation would be 100% discount within 7 days of a surgical/Medical case.

For all procedures, surgeries, diagnostic services and all other services rendered while the patient is in the wards, billing is always done at the current bed category charges. Only one consultation of operating surgeon should be charge on the day of surgery.

If the patient admitted after 12 PM, only one visit to be charged for primary consultant.

Only two IP consultation is applicable for primary consultant & second consultation will be charged after 4 PM.

Only one Cross/referring consultation for different specialty will be charged.

BILLING OF OT & ANAESTHESIA SERVICES PROCEDURE / SURGERY CHARGES

The charges for any Procedure/Surgery shall be according to the Schedule of Charges. OPD/IPD Procedures against surgeries/ procedures/operations is Surgeon fees only. Anesthesia charges (40%), OT charges (100%) are additional & Assistant

surgeon charges (35%) if applicable. Medicines/ consumables/investigations are billed extra.

For all packages/procedures/surgery/operations, the medicines/consumables/implants are charged extra separately


Billing Guidelines for OT

1. Two Surgeries/ Procedures in single sitting, following billing policy shall be applicable: -

a. Higher value surgery shall be considered as principal surgery & shall be charged 100% of procedure Charges/ package charges

b. Subsequent surgery with Lower value shall be considered as minor surgery. c. Standard inclusions shall remain as per principal surgery. d. Shall be subject to differential pricing as per room category.

POLICY FOR MULTIPLE-SURGERY BILLING (same sitting):

(A) For surgeries billed as standalone services (open billing):

The following is the policy for billing when more than one surgical service is rendered to a patient in the same sitting:

SINGLE INCISION MULTIPLE INCISION

SINGLE DEPARTMENT S1 – to be billed at 100% of the rack rate S1 – to be billed at 100% of the rack rate

S2 – to be billed at 50% of the rack rate S2 – to be billed at 100% of the rack rate

MULTIPLE DEPARTMENTS S1 – to be billed at 100% of the rack rate S1 – to be billed at 100% of the rack rate


(B) For services billed as packages: The following is the policy for billing when more than one packages service is rendered to a patient in the same sitting:

SINGLE INCISION MULTIPLE INCISION

SINGLE DEPARTMENT S1 – to be billed at 100% of the rack rate S1 – to be billed at 100% of the rack rate


MULTIPLE DEPARTMENTS S1 – to be billed at 100% of the rack rate S1 – to be billed at 100% of the rack rate



Billing Guidelines for Packages

Differential charges for procedure, packages, consultant visit apply for different categories of room. The packages mentioned are for specified number of days only. Details are mentioned below.

CARDIOLOGY PACKAGES INCLUSIONS /EXCLUSIONS: - All implants like Coil, Valve, Devices, etc are not included in package & will be charged as per applicable hospital tariff.

CAG/PAG/EPS/RFA packages will be one day & all other procedures are up-to 3 days.

Charges are inclusive of routine Investigation, define bed charges. All medicines, Consumables & Implants are not included in the package and will be charged separately.

Any stay beyond the above package days would be chargeable. Blood Processing Charge would be charged extra.

Acute cardiac incident patients admitted through emergency and undergo cath intervention within 4 hours of admission will be charged for primary PTCA

CARDIAC SURGERY PACKAGES INCLUSIONS /EXCLUSIONS: -

Cost of any Implants like valve, conduit, Coils, grafts, blood etc. are not included in the package and will be charged at applicable hospital tariff

Charges are inclusive of routine Investigation, define bed charges. All medicines, Consumables & Implants are not included in the package and will be charged separately.

Length of stay for would be 8 days. Package will start one day before surgery.

Any stay Beyond the package period would be chargeable.


ORTHO PACKAGES INCLUSIONS /EXCLUSIONS: -

Arthroscopy Package is for 1 day

Charges are inclusive of routine Investigation, Bed charges, Operation charges only.

Total HIP/Knee Replacement B/L & U/L packages duration is 7 days & 5 days respectively.

All Medicines, Consumables & Implants are not included in the package and will be charged separately.

Any stay Beyond the package period would be chargeable.

UROLOGY SURGERY PACKAGES INCLUSIONS /EXCLUSIONS: -

Charges are inclusive of Bed charges (TURP & PCNL -4 days),( BNI, URS,URS+LITH, TURBT,CLP/PCCL 3 Days),(OIU,TURP,BNI and laser surgery 2 Days)(Renal Transplant 10 Days) , Operation charges only.

Any stay beyond the package period would be chargeable on actual.


All other procedures & cross consultations by other doctors charged extra.

Pre surgical profile include in package.

All implants, prosthesis, etc. charged extra.

Biopsy would be charged extra

GENERAL SURGERY PACKAGES INCLUSIONS /EXCLUSIONS: -

Charges are inclusive of Bed charges up to 2 Days, Operation charges only.

Any stay beyond the package period would be chargeable on actual

All other procedures & cross consultations by other doctors charged extra.


Biopsy would be charged extra

All implants, prosthesis, etc. charged extra.


Procedures/Operations/Surgeries inclusions/Exclusions in all departments: -

The tariffs mentioned against surgeries/ procedures/operations is Surgeon fees only. Anesthesia, Anesthesiologist (40%), OT charges (100%) & {Assistant Surgeon (35%) if applicable} are additional. All Medicines, Consumables & Implants are not included in the package and will be charged separately. Surgery charges break-up as below.

In instances where tariff has not been mentioned against a particular category of room, then the standard charges will apply. New investigations, procedures & packages may be added at a later date, tariffs for which will be fixed at the sole discretion of the hospital. The tariff list enclosed is subject to revision at the discretion of the hospital.


Surgeon Fee 100%

OT Charged 100%

Anesthetist charges 40% Assistant Surgeon fee 35%

Cath Lab charges 40%


INDEX

S. No. Particulars Page No.

1 Administration 1 2 Blood Bank 2

3 Breast Surgery 3

4 Cardiac Surgery 4 5 Cardiology 5

6 Common Procedure 7

7 Dental 11

8 Dermatology 19 9 ENT 19

10 Gastroenterology 24

11 General Surgery 27 12 Gynecology 33

13 Interventional Neurology 35

14 Interventional Radiology 36 15 Laboratory 40

16 Liver Transplant 88

17 Medical Oncology 90 18 Nephrology 91

19 Neurology 92

20 Neuro-Surgery 93 21 Nuclear Medicine 96

22 Obstetrics 97

23 Ophthalmology 99

24 Orthopedics 102 25 Others 109

26 Physiotherapy 109

27 Plastic Surgery 112 28 Pulmonology 113

29 Radiology 116

30 Radiotherapy 140 31 Spine Surgery 145

32 Surgical Oncology 145

33 Urology 149

34 Vascular Surgery 154

Servie Name Service Code OPD General Semi Private Private Suite Deluxe Suite

ADMISSION SVC000007 1000 1000 1000 1000 1000 1000REGISTRATION SVC000006 150 150 150 150 150 150AMBULANCE ADVANCED LIFE SUPPORT - FIRST 10 KMS SVC000023 2310 2310 2310 2310 2310 2310AMBULANCE ADVANCED LIFE SUPPORT - PER ADDNL KM SVC000024 50 50 50 50 50 50AMBULANCE BASIC LIFE SUPPORT - FIRST 10 KMS SVC000019 2100 2100 2100 2100 2100 2100AMBULANCE BASIC LIFE SUPPORT - PER ADDNL KM SVC000020 40 40 40 40 40 40AMBULANCE DOCTOR CHARGES - LONG TRIP SVC000120 3680 3680 3680 3680 3680 3680AMBULANCE DOCTOR CHARGES - SHORT TRIP SVC000121 2890 2890 2890 2890 2890 2890AMBULANCE PATIENT TRANSPORT - NURSE UPTO 8 HRS SVC000026 810 810 810 810 810 810AMBULANCE PATIENT TRANSPORT - PARAMEDIC UPTO 8 HRS SVC000032 580 580 580 580 580 580AMBULANCE PATIENT TRANSPORT - SERVICE CHARGES SVC000022 1050 1050 1050 1050 1050 1050BED CHARGES - CRITICAL CARE AREA SVC000004BED CHARGES - DAY CARE SVC000064BED CHARGES - DAY CARE - UPTO 12 HOURS SVC000147BED CHARGES - DAY CARE - UPTO 3 HOURS SVC000195BED CHARGES - DAY CARE - UPTO 6 HOURS SVC000146BED CHARGES - WARD SVC000005 4500 6500 10000 15000 16500BFL Processing Fee SVC011425BFL Service charges (including GST) SVC011424CD MAKING SVC000008 270 360 410 460 490 520CD REVIEW CHARGES SVC012968 270 360 410 460 490 520CLEFT LIP REPAIR SVC000212 6100 8000 9200 10400 11600CONSULTATION - FIRST VISIT SVC000001 1200CONSULTATION - IP SVC000697 1400 1600 1800 2000 2200CONSULTATION - REVISIT SVC000002 1200CONSULTATION- DIETITIAN SVC000113CROSS CONSULTATION - IP SVC000698 1400 1600 1800 2000 2200Diode Laser Machine Charges SVC013185 21000 21000 27300 31500 35700 39900EMERGENCY CONSULTATION SVC013799EMERGENCY CONSULTATION CHARGE SVC000166INITIAL ASSESSMENT CHARGES SVC000014 710 930 1070 1210 1280 1350

Administrative

145003200300014001800

690130

500

14001400

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteNONINVASIVE VENTILATOR (NIV) SVC000089OBSERVATION CHARGES - PER HOUR SVC000110OPD OBSERVATION (UP TO 2 HOURS) SVC000011 610 800 920 1040 1100 1160PULMONARY ARTERY CATHETERIZATION (PAC) SVC000051 6930 9010 10400 11790 13170VENTILATOR - UPTO 12 HOURS SVC000118BIOMEDICAL WASTE MANAGEMENT SERVICE SVC012478 1000 1000 1000 1000 1000 1000

COVID-19 PACKAGE - ICU WITH VENTILATOR CARE - GURUGRAM PKG021209 18000 18000 18000 18000 18000

COVID-19 PACKAGE - ICU WITHOUT VENTILATOR CARE - GURUGRAM PKG021210 15000 15000 15000 15000 15000COVID-19 PACKAGE - ISOLATION BEDS - GURUGRAM PKG021211 10000 10000 10000 10000 10000COVID-19 TRUENAT SVC012427 1250 1250 1250 1250 1250 1250Infection Control Charges SVC013013 1000 1000 1000 1000 1000 1000RMO CHARGE SVC013336 750 750 750 750 750 750

CONVALESCENT PLASMAPHERESIS (HALF UNIT) SVC012648 6070 7900 9110 10320 10930 11540CONVALESCENT PLASMAPHERESIS(FULLÂ UNIT ) SVC012647 12710 16530 19070 21610 22880 24150APHRESIS PLATELETS PROCESSING CHARGE SVC000281 11000 11000 11000 11000 11000 11000BLOOD GROUP SVC000238 110 110 110 110 110 110BLOOD GROUPING & CROSS MATCHING CHARGES SVC000280 940 940 940 940 940 940BLOOD PRODUCTS IRRADIATION PER UNIT SVC000256 80 80 80 80 80 80CROSS MATCHING - COMPONENT SVC000284 600 600 600 600 600 600CROSS-MATCHING CHARGES SVC000260 600 600 600 600 600 600CRYO POOR PLASMA SVC000254 800 800 800 800 800 800CRYO PRECIPITATE SVC000255 500 500 500 500 500 500CRYO PRECIPITATE COMP SVC000277 500 500 500 500 500 500DIRECT COOMBS TEST SVC000257 520 520 520 520 520 520FRESH FROZEN PLASMA (FFP) SVC000239 800 800 800 800 800 800FRESH FROZEN PLASMA (FFP)_COMPONENT SVC000273 800 800 800 800 800 800FRESH FROZEN PLASMA (NAT TESTED) SVC000244 1600 1600 1600 1600 1600 1600GRANULOCYTOPHERESIS SVC000246 7650 7650 7650 7650 7650 7650INDIRECT COOMBS TEST SVC000258 530 530 530 530 530 530

Blood Bank

2703050

2680

Page 2 of 155

Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteIRRADIATED PLATELETS SVC000265 350 350 350 350 350 350IRRADIATION - COMPONENT SVC000285 80 80 80 80 80 80LEUCOCYTE POOR RED CELLS SVC000248 1300 1300 1300 1300 1300 1300LEUCOFILTRATION - COMPONENT SVC000287 1300 1300 1300 1300 1300 1300LEUCOREDUCED AND IRRADIATED PACKED RED BLOOD CELLS SVC000263 1350 1350 1350 1350 1350 1350LEUCOREDUCED AND IRRADIATED PLATELETS SVC000266 420 420 420 420 420 420NAT CHARGES-CRYO POOR PLASMA SVC013423 800 800 800 800 800 800NAT CHARGES-FRESH FROZEN PLASMA (FFP) SVC013421 800 800 800 800 800 800NAT CHARGES-PACKED RED BLOOD CELLS (PC) -SAGM SVC013426 1000 1000 1000 1000 1000 1000NAT CHARGES-PLATELET CONCENTRATE SVC013422 750 750 750 750 750 750NAT CHARGES-TYPE A SVC000282 800 800 800 800 800 800NAT CHARGES-TYPE B SVC000283 750 750 750 750 750 750NAT TESTED COMPONENT SVC013406 1000 1000 1000 1000 1000 1000PACKED RED BLOOD CELLS (NAT TESTED) SVC000242 2400 2400 2400 2400 2400 2400PACKED RED BLOOD CELLS (PC) SVC000240 1400 1400 1400 1400 1400 1400PACKED RED BLOOD CELLS (PC) COMP SVC000274 1400 1400 1400 1400 1400 1400PACKED RED BLOOD CELLS (PC) -SAGM SVC000288 1400 1400 1400 1400 1400 1400PERIPHERAL BLOOD STEM CELL COLLECTION (PBSC) SVC000252 12600 12600 12600 12600 12600 12600PLATELET CONCENTRATE SVC000241 850 850 850 850 850 850PLATELET CONCENTRATE COMP SVC000275 850 850 850 850 850 850PLATELET CONCENTRATE(NAT TESTED) SVC000300 1000 1000 1000 1000 1000 1000PORTION BAG CHARGES SVC000278 250 250 250 250 250 250RANDOM DONOR PLATELETPHERESIS SVC000272 1600 1600 1600 1600 1600 1600RANDOM DONOR PLATELETPHERESIS (NAT TESTED-FULL BAG) SVC000243 2500 2500 2500 2500 2500 2500SDP SCREENING SVC000271 600 600 600 600 600 600SINGLE DONOR PLATELETPHERESIS (FULL BAG) SVC000250 11000 11000 11000 11000 11000 11000SINGLE DONOR PLATELETPHERESIS (FULL BAG) COMP SVC000276 11000 11000 11000 11000 11000 11000SINGLE DONOR PLATELETPHERESIS (HALF BAG) SVC000249 3450 3450 3450 3450 3450 3450THERAPEUTIC VENESECTION SVC000259 600 600 600 600 600 600WARM AGGLUTININS TEST SVC000268 210 210 210 210 210 210WHOLE BLOOD SVC000245 2250 2250 2250 2250 2250 2250WHOLE BLOOD (WB)_COMPONENT SVC000290 2250 2250 2250 2250 2250 2250

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BREAST - SENTINEL LYMPH NODE BIOPSY SVC000310 17400 17400 22700 26100 29600 33100BREAST CONSERVATION SURGERY SVC000307 37800 49200 56700 64300 71900BREAST LUMPECTOMY SVC000324 8700 11400 13100 14800 16600BREAST RECONSTRUCTION WITH LOCAL FLAP SVC000308 55500 72200 83300 94400 105500INCISION AND DRAINAGE SVC000312 7000 9100 10500 11900 13300LAPAROSCOPIC ABDOMINOPERINEAL RESECTION SVC000313 37000 48100 55500 62900 70300MICRODOCHECTOMY SVC000315 13900 18100 20900 23700 26500MODIFIED RADICAL MASTECTOMY SVC000316 43400 56500 65100 73800 82500RADICAL MASTECTOMY SVC000317 31000 40300 46500 52700 58900UNILATERAL GYNAECOMASTIA_GST SVC000329 21000 27300 31500 35700 39900

ALCAPA - A (EM) PKG PKG002671 231000 300300 346500 392700 438900AORTIC ARCH REPAIR - A (EM) PKG PKG002618 288800 375500 433200 491000 548800AP WINDOW - A (EM) PKG PKG002621 207900 270300 311900 353500 395100ARTERIAL SWITCH / ASO - A (EM) PKG PKG002622 265700 345500 398600 451700 504900ASD - A (EM) PKG PKG002625 184800 240300 277200 314200 351200AV CANAL - A (EM) PKG PKG002626 184800 240300 277200 314200 351200AV REPAIR - A (EM) PKG PKG002627 157500 204800 236300 267800 299300AVR - A (EM) PKG PKG002628 199500 259400 299300 339200 379100BD GLEN - A (EM) PKG PKG002630 173300 225300 260000 294700 329300BD GLEN ON CPB - A (EM) PKG PKG002631 173300 225300 260000 294700 329300BENTAL - A (EM) PKG PKG002632 207900 270300 311900 353500 395100BT SHUNT - A (EM) PKG PKG002633 92400 120200 138600 157100 175600CABG - A (EM) PKG PKG002634 189000 245700 283500 321300 359100CABG + VSD - A (EM) PKG PKG003634 288800 375500 433200 491000 548800CABG WITH AVR - A (EM) PKG PKG002637 254100 330400 381200 432000 482800CABG WITH DVR - A (EM) PKG PKG002636 173300 225300 260000 294700 329300CABG WITH MVR - A (EM) PKG PKG002638 254100 330400 381200 432000 482800COARCTATION - A (EM) PKG PKG002642 115500 150200 173300 196400 219500DVR - A (EM) PKG PKG002645 168000 218400 252000 285600 319200EBSTEIN - A (EM) PKG PKG002646 173300 225300 260000 294700 329300

Breast Surgery

Cardiac Surgery

Page 4 of 155

Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteEMBOLECTOMY SVC001535 16200 21100 24300 27600 30800FEMORAL ARTERY PSEUDOANEURYSM REPAIR PKG PKG021464 26300 34200 39500 44800 50000MV REPAIR - A (EM) PKG PKG002648 157500 204800 236300 267800 299300MVR - A (EM) PKG PKG002649 199500 259400 299300 339200 379100MVR + TV REPAIR - A (EM) PKG PKG002614 283500 368600 425300 482000 538700PA BANDING - A (EM) PKG PKG002651 105000 136500 157500 178500 199500PDA - A (EM) PKG PKG002652 94500 122900 141800 160700 179600PERICARDIECTOMY - A (EM) PKG PKG002653 138600 180200 207900 235700 263400RE-DO AVR PKG003386 288800 375500 433200 491000 548800ROTABLATION SVC001530 105000 136500 157500 178500 199500STERNAL WIRING SVC011950 8600 11200 12900 14700 16400TAPVC - A (EM) PKG PKG002669 207900 270300 311900 353500 395100TCPC (COMPLETE FONTAN) - A (EM) PKG PKG002662 207900 270300 311900 353500 395100TOF - A (EM) PKG PKG002665 183800 239000 275700 312500 349300TRANS AORTIC VALVE IMPLANTATION (TAVI) (EM)PKG PKG019479 336000 436800 504000 571200 638400TV REPAIR - A (EM) PKG PKG003648 157500 204800 236300 267800 299300VSD - A (EM) PKG PKG002668 168000 218400 252000 285600 319200

AORTA CELIAC SUPERIOR MESENTERIC ARTERY BYPASS GRAFT PKG PKG022365 150000 195000 225000 255000 285000

AICD IMPLANTATION - DOUBLE (EM) PKG PKG000431 104000 135200 156000 176800 197600AICD IMPLANTATION - SINGLE (EM) PKG PKG000430 70400 91600 105600 119700 133800ANGIOGRAM (EM) PKG PKG000406 8400 11000 12600 14300 16000

ANGIOGRAM+MINI ELECTROPHYSIOLOGY STUDY (MINI EPS)_PKG PKG003170 26300 34200 39500 44800 50000ANGIOPLASTY - (EM) (COMPLEX) PKG PKG003181 136500 177500 204800 232100 259400ANGIOPLASTY (EM) PKG PKG000416 115500 150200 173300 196400 219500AORTIC STENT GRAFTING (EM) PKG PKG000420 115500 150200 173300 196400 219500ASD DEVICE CLOSURE (EM) PKG PKG000443 72700 94600 109100 123600 138200BALLOON ATRIAL SEPTOSTOMY (EM) PKG PKG000396 25700 33500 38600 43700 48900BALOON VALVULOPLASTY - MITRAL (EM) PKG PKG000433 82600 107400 123900 140500 157000CARDIAC CATH (EM) PKG PKG000411 7000 9100 10500 11900 13300

Cardiology

Page 5 of 155


CARDIAC CATH, ASD DEVICE CLOSURE (SAME SITTING) (EM) PKG PKG000444 88500 115100 132800 150500 168200CARDIAC MEMOS (PER WEEK) SVC000403 3000 3000 3900 4500 5100 5700CARDIAC MEMOS EVENT RECORDING - PER DAY SVC000404 470 620 710 800 850 900CARDIOVERSION SVC002194 5200 6800 7800 8900 9900CAROTID ANGIOGRAM (EM) PKG PKG003285 6400 8400 9600 10900 12200CORONARY ANGIOGRAM, RENAL ANGIOGRAM (EM) PKG PKG000414 7000 9100 10500 11900 13300CRT - P IMPLANTATION (EM) PKG PKG000428 115500 150200 173300 196400 219500CRT-D IMPLANTATION (BI-VENTRICULAR & PACING) - (EM) PKG PKG002670 127100 165300 190700 216100 241500DOBUTAMINE STRESS ECHO (INCLUDING CONTRAST CHARGES) SVC000424 5960 7750 8940 10140 10730 11330DOBUTAMINE STRESS TEST (ECHO) SVC000421 4860 6320 7290 8270 8750 9240ECG SVC000345 310 410 470 530 560 590ECHO 2D SVC002195 2840 3700 4260 4830 5120 5400ECHO 3D SVC011493 2630 3420 3950 4480 4740 5000ECHO CARDIOGRAPHY (CRT) SVC000397 3120 4060 4680 5310 5620 5930ECHO COLOR DOPPLER SVC000398 2230 2900 3350 3800 4020 4240ECHO COLOUR DOPPLER - PEDIATRIC SVC000399 2070 2700 3110 3520 3730 3940ECHO SCREENING SVC000346 1840 2400 2760 3130 3320 3500ECHO SCREENING - PEDIATRIC SVC000400 2380 3100 3570 4050 4290 4530ECHOCARDIOGRAM BEDSIDE SVC000427 2780 3620 4170 4730 5010 5290ELECTRO PHYSIOLOGIC STUDY WITH 2D SVC000347 6700 8800 10100 11400 12800ELECTRO PHYSIOLOGIC STUDY WITH 2D (EM) PKG PKG000437 20000 26000 30000 34000 38000ELECTRO PHYSIOLOGY STUDY WITH RADIO FREQUENCY ABLATION (EM) PKG PKG000404 89300 116100 134000 151900 169700ELECTROPHYSIOLOGY STUDY + RADIO FREQUENCY ABLATION (EPS+RFA) SVC012885 61500 80000 92300 104600 116900ENDOMYOCARDIAL BIOPSY PKG PKG000402 15600 15600 20300 23400 26600 29700EXTENDED HOLTER MONITORING/PER DAY SVC000460 1920 2500 2880 3270 3460 3650FOETAL ECHO SVC000401 7230 9400 10850 12300 13020 13740FOETAL ECHO CD CHARGES SVC000402 180 240 270 310 330 350FRACTIONAL FLOW RESERVE (FFR) SVC000454 52500 68300 78800 89300 99800HOLTER MONITORING SVC000349 2210 2880 3320 3760 3980 4200

Page 6 of 155

Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteICD IMPLANTATION - SINGLE FOLLOW UP SVC000394 1800 2400 2700 3100 3500INTRA-VASCULAR ULTRASOUND (IVUS) - PKG PKG019994 30000 39000 45000 51000 57000IVC FILTER IMPLANTATION SVC000350 47400 61700 71100 80600 90100MINI ELECTROPHYSIOLOGY STUDY (MINI EPS)_PKG PKG009156 12600 16400 18900 21500 24000MYOCARDIAL CONTRAST ECHOCARDIOGRAPHY SVC000422 1390 1810 2090 2370 2510 2650

OPTICAL COHERENCE TOMOGRAPHY -CORONARY ARTERIES(OCT) SVC000455 34700 45200 52100 59000 66000PERICARDIOCENTESIS (PERICARDIAL TAP) SVC000405 6000 7800 9000 10200 11400PERIPHERAL ANGIOGRAM (EM) PKG PKG000409 7000 9100 10500 11900 13300PG REPLACEMENT (EM) PKG PKG000425 40500 52700 60800 68900 77000RADIO FREQUENCY ABLATION (EM) PKG PKG000439 62400 81200 93600 106100 118600RADIO FREQUENCY ABLATION (RFA) COMPLEX (EM) PKG PKG003217 86700 112800 130100 147400 164800SALINE CONTRAST ECHOCARDIOGRAPHY SVC000423 730 950 1100 1250 1320 1390STRESS ECHO SVC000357 4150 5400 6230 7060 7470 7890TEE SVC000358 5900 5900 7700 8900 10100 11300TEMPORARY PACEMAKER IMPLANTATION (TPI) PKG PKG005034 11600 15100 17400 19800 22100TILT TABLE TEST SVC000361 3650 4750 5480 6210 6570 6940TREADMILL TEST SVC000362 2070 2700 3110 3520 3730 3940VSD DEVICE CLOSURE (EM) PKG PKG000445 144400 187800 216600 245500 274400PACEMAKER IMPLANTATION - DOUBLE CHAMBER FOLLOW UP SVC000395 1760 1760 1760 1760 1760 1760PACEMAKER IMPLANTATION - SINGLE CHAMBER FOLLOW UP SVC000396 1430 1430 1430 1430 1430 1430CHECK ANGIO_PKG PKG008424 11200 14600 16800 19100 21300CHECK ANGIOGRAM / VENOGRAM SVC003409 5800 7600 8700 9900 11100IVC FILTER_PKG PKG007935 45800 59600 68700 77900 87100

90 DEGREE HOPKINS EXAMINATION SVC011946 1200 1200 1600 1800 2100 2300ALPHA BED CHARGES (NIMBUS) - PER DAY SVC000593ALPHA BED CHARGES (TRANS XL) - PER DAY SVC000594AMBULATORY BP MONITORING - 24 HOURS SVC000646 2380 3100 3570 4050 4290 4530ARTERIAL LINE INSERTION SVC000683 2900 2900 3800 4400 5000 5600AUTOLOGUS SERUM SKIN TEST(ASST) SVC000818 1890 1890 2520 2840 3260 3680BILIRUBINOMETRY-TRANSCUTANEOUS-(TCB) SVC000768 320 320 420 530 630 630

540810

Commonn Procedure

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteBLOOD GAS ANALYSIS SVC002193 1020 1330 1530 1740 1840 1940BLOOD SUGAR STRIP TEST SVC000690 80 110 120 140 150 160BONE MARROW ASPIRATION SVC000685 7000 7000 9100 10500 11900 13300BOTOX INJECTIONS SVC000657 7300 7300 9500 11000 12500 13900C - ARM - PER HOUR SVC000701 1530 1530 1530 1530 1530 1530CAVITRON ULTRASOUND SURGICAL ASPIRATOR (CUSA) SVC000719 5150 5150 6720 7770 8820 9870CENTRAL LINE DRESSING SVC000661 320 320 420 530 630 630CENTRAL LINE INSERTION - ADULT SVC000684 5500 5500 7200 8300 9400 10500CENTRAL LINE INSERTION - PEDIATRIC SVC000635 2800 2800 3700 4200 4800 5400CLOSURE COMPLEX SVC012883 34700 34700 45200 52100 59000 66000CONTINOUS NERVE BLOCK SVC000879 4700 4700 6200 7100 8000 9000COOLING BLANKET - PER DAY SVC000721 1580 1580 2100 2420 2730 3050DJ STENT REMOVAL SVC000674 5600 7300 8400 9600 10700DRESSING - WOA SVC000681 600 600 800 900 1100 1200DRESSING - WOA-MAJOR-OP (INCLUDING MATERIALS) SVC000730 2300 2300 3000 3500 4000 4400DRESSINGS LARGE SVC000746 980 1280 1470 1670 1770 1870DVT PUMP - PER DAY SVC000596ECG EMERGENCY SVC000643 370 490 560 630 670 710ECMO CHARGES PER DAY SVC000825ECMO INITIATION CHARGES-COATED SVC000848ENDOSCOPIC REMOVAL OF FOREIGN BODY(FB) SVC000682 10900 14200 16400 18600 20800EPIDURAL CATHETER INSERTION SVC000649 4620 4620 6090 6930 7880 8820EQUIPMENT RENTAL CHARGES SVC000736 840 1100 1260 1430 1520 1600EXCHANGE TRANSFUSION SVC000613 13100 13100 17100 19700 22300 24900EXCISION BIOPSY - LA SVC000616 5800 5800 7600 8700 9900 11100FIBGRAFF TEST SVC000901 2550 2550 2550 2550 2550 2550FLUID TAPPING ASCITIC (DIAGNOSTIC) SVC000590 700 700 1000 1100 1200 1400FLUID TAPPING ASCITIC (THERAPEUTIC) SVC000686 4200 4200 5500 6300 7200 8000FOLEY S CATHETERIZATION SVC000678 1800 1800 2400 2700 3100 3500FOLEY'S CATHETER REMOVAL SVC000615 300 300 400 500 600 600FOREIGN BODY REMOVAL SVC000591 5200 5200 6800 7800 8900 9900GASTRIC LAVAGE/STOMACH WASH SVC000662 2400 2400 3200 3600 4100 4600

700

23100173250

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteGENERAL SUTURE REMOVAL SVC000810 630 630 840 950 1160 1260

HARMONIC SCALPEL - PROBE DISPOSABLE (LAPAROSCOPIC SURGERY) SVC000838HARMONIC SCALPEL - PROBE DISPOSABLE (OPEN SURGERY) SVC000839HEMODIALYSIS CATHETER INSERTION SVC000856 3500 3500 4600 5300 6000 6700HEPARINASE TEST SVC000899 2910 2910 2910 2910 2910 2910HFNC INITIATION CHARGES SVC000889 2890 2890 2890 2890 2890 2890HIGH FLOW NASAL CANNULA DAILY CHARGES SVC000854 920 920 920 920 920 920HOME SAMPLE COLLECTION CHARGES (LAB) SVC000769 350 460 530 600 630 670HOME VISIT CHARGES SVC000735 630 630 840 950 1160 1260I.V. FLUID INJECTION CHARGES SVC000693 160 160 160 160 160 160IABP SVC000605 3500 4600 5300 6000 6700INCISION & DRAINAGE - LA SVC000688 900 1200 1400 1600 1800INCISIONAL BIOPSY SVC000651 3500 3500 4600 5300 6000 6700INFUSION PUMP - PER DAY SVC000612 280 370 420 480 510 540INJECTION CHARGES SVC000694 130 170 200 230 240 250INJECTION IV EMERGENCY SVC000644 300 300 400 500 600 600INTERCOSTAL DRAIN INSERTION (ICD INSERTION) SVC000606 5100 5100 6700 7700 8700 9700INTRA ARTERIAL RECANALIZATION SVC012961 29400 29400 38300 44100 50000 55900INTUBATION SVC000592 5500 7200 8300 9400 10500INTUBATION (PAEDIATRIC) SVC000724 2600 2600 3400 3900 4500 5000IV CANNULA INSERTION - EMERGENCY SVC000774 1100 1100 1500 1700 1900 2100KAOLIN TEST SVC000898 1810 1810 1810 1810 1810 1810LAPAROSCOPIC INSTRUMENT CHARGES SVC000707 5200 6800 7800 8900 9900LIFESTYLE MODIFICATION PROGRAM SVC000751 630 630 840 950 1160 1260LIGASURE CHARGES SVC000706 7000 9100 10500 11900 13300LUMBAR PUNCTURE SVC000608 5100 5100 6700 7700 8700 9700LYMPH NODE BIOPSY SVC000647 5800 5800 7600 8700 9900 11100LYMPH NODE BIOPSY UNDER GA-PKG PKG005234 16600 16600 21600 24900 28300 31600MANUAL EVACUATION SVC000778 3890 3890 5150 5880 6620 7460MEDIUM SEDATION CHARGES SVC000881 1830 1830 1830 1830 1830 1830MINOR DRESSING SVC000819 530 530 740 840 950 1050

137304620

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteMLC CHARGES SVC000597 880 880 880 880 880 880Mucormycosis Daycare Package PKG021725 2100 2800 3200 3600 4000MYOCUTANEOUS / CUTANEOUS FLAP SVC000869 19700 25700 29600 33500 37500NEBULISATION SVC000691NEEDLE BIOPSY SVC000808 3800 3800 5000 5700 6500 7300NONINVASIVE VENTILATOR (NIV) FOR 12 HRS SVC000853 2290 2290 2290 2290 2290 2290OXYGEN - PER DAY SVC000611OXYGEN - PER HOUR SVC000671PEG TUBE FEEDING SVC000737 1160 1160 1580 1790 2000 2210PERCUTANEOUS TRACHEOSTOMY SVC000609 11000 11000 14300 16500 18700 20900PICC LINE INSERTION SVC000610 6700 6700 8800 10100 11400 12800PLAIN CATHERIZATION SVC000812 2800 2800 3700 4200 4800 5400PLATMETER TEST SVC000902 14310 14310 14310 14310 14310 14310PORT INSERTION _PKG PKG007945 48800 63500 73200 83000 92800PRIMARY CLOSURE - SIMPLE SVC012910 23100 23100 30100 34700 39300 43900PUNCH BIOPSY - LA SVC000829 3000 3000 3900 4500 5100 5700RAPIGRAFF TEST SVC000900 2430 2430 2430 2430 2430 2430RYLES TUBE FEEDING SVC000716 960 1250 1440 1640 1730 1830RYLES TUBE INSERTION SVC000634 1400 1400 1900 2100 2400 2700SECONDARY SUTURING LARGE SVC011949 5800 5800 7600 8700 9900 11100SEDATION CHARGES SVC000638 3500 3500 4600 5300 6000 6700SHORT SEDATION CHARGES SVC000880 1530 1530 1530 1530 1530 1530SINGLE ABSCESS SVC000641 1800 1800 2400 2700 3100 3500SINGLE SHOT NERVE BLOCK SVC000878 4800 4800 6300 7200 8200 9200SKIN PRICK TEST SVC000744 1500 1500 2000 2300 2600 2900SLIDE CHARGES SVC000695 570 750 860 970 1030 1090SUPERFICIAL ABSCESS DRAINAGE (SINGLE) SVC000640 1700 1700 2300 2600 2900 3300SUPRAPUBIC BLADDER ASPIRATION SVC000720 280 370 420 480 510 540SUPRAPUBIC CATHETERISATION SVC000855 4410 4410 5780 6620 7560 8400SUTURE REMOVAL LARGE SVC011947 1800 1800 2400 2700 3100 3500SUTURE REMOVAL MEDIUM SVC011948 1200 1200 1600 1800 2100 2300SW ENEMA SVC000689 360 470 540 620 650 690

330

58070

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteT PIECE INSERTION FOR TRACHEOSTOMY SVC000642 300 300 400 500 600 600TRACHEOSTOMY SVC000621 11600 11600 15100 17400 19800 22100TRACHEOSTOMY CARE SVC000717 960 1250 1440 1640 1730 1830TRANS SPHENOIDAL SURGERY SVC000857 63600 82700 95400 108200 120900TRIPLE SCOPY SVC011944 5300 5300 6900 8000 9100 10100TRIPLE SCOPY + BIOPSY SVC011945 6500 6500 8500 9800 11100 12400VENTILATOR (BIPAP/CPAP) - PER DAY SVC000700VENTILATOR INITIATION AND STABILIZATION SVC000672 7600 7600 9900 11400 13000 14500WIDE EXCISION SVC000868 17400 22700 26100 29600 33100WOUND DEBRIDEMENT - LA SVC000680 9200 9200 12000 13800 15700 17500

ACRYLIC CROWN SVC001605 600 600 800 900 1100 1200ARCH BAR REMOVAL SVC000578 6100 6100 8000 9200 10400 11600ADDITIONAL CAST PARTIAL DENTURE - PER TOOTH SVC001606 8000 8000 10400 12000 13600 15200ALVEOLOPLASTY SVC001608 3000 3000 3900 4500 5100 5700ALVEOLOPLASTY/TOOTH AREA SVC002007 4200 4200 5500 6300 7200 8000APEXIFICATION MULTIPLE VISIT(CA(OH)2 SVC002091 7000 7000 9100 10500 11900 13300APEXIFICATION TWO VISIT (MTA) SVC002092 7500 7500 9800 11300 12800 14300APICOECTOMY ANTERIOR PER TOOTH SVC002001 8100 8100 10600 12200 13800 15400APICOECTOMY MULTIPLE ROOT SVC001798 11600 11600 15100 17400 19800 22100APICOECTOMY PER ADDITIONAL TOOTH SVC002100 12700 12700 16600 19100 21600 24200APICOECTOMY POSTERIOR PER TOOTH SVC002002 9300 9300 12100 14000 15900 17700ARCHBAR FIXATION DENTOALVEOLAR FRACTURE SEGMENT SVC002101 5700 5700 7500 8600 9700 10900BIOPSY EXCISIONAL(DENTAL) SVC001932 9900 9900 12900 14900 16900 18900BIOPSY INCISIONAL - SOST TISSUE SVC002103 12600 12600 16400 18900 21500 24000BIOPSY INCISIONAL(DENTAL) SVC001933 4400 4400 5800 6600 7500 8400BITE RAISING APPLIANCE/ NIGHT GUARD SVC001802 2800 2800 3700 4200 4800 5400BLEACH TRAY_GST SVC001612 1800 1800 2400 2700 3100 3500BLEACHING ( PER TOOTH) SVC001895 16100 16100 21000 24200 27400 30600BLEACHING OF TEETH DOUBLE ARCH(HOME BLEACH) SVC001926 1700 1700 2300 2600 2900 3300BLEACHING OF TEETH SINGLE ARCH(HOME BLEACH) SVC001925 2300 2300 3000 3500 4000 4400BONE AUGMENTATION SVC001803 15400 15400 20100 23100 26200 29300

Dental

4460

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteBONE GRAFT ON EACH IMPLANT SVC002029 12700 12700 16600 19100 21600 24200BONE GRAFTING-DENTAL SVC001613 4500 4500 5900 6800 7700 8600CLOSED REDUCTION OF DISPLASED MANDIBULAR FRACTURE (MULTIPLE) SVC002104 51900 51900 67500 77900 88300 98700CLOSED REDUCTION OF LF I SVC002105 31700 31700 41300 47600 53900 60300CLOSED REDUCTION OF LF I WITH MPS SVC002106 18400 18400 24000 27600 31300 35000CLOSURE OF ORO-ANTRAL FISTULA SVC002147 19600 19600 25500 29400 33400 37300COMPLETE DENTURE - BIOFUNCTIONAL PROSTHETIC SYSTEM (BPS) WITH EQUIPMENT SVC001622 46100 46100 60000 69200 78400 87600COMPLETE DENTURE - BIOFUNCTIONAL PROSTHETIC SYSTEM (BPS) WITHOUT EQUIPMENT (PROCESSING) SVC001623 44500 44500 57900 66800 75700 84600COMPLETE DENTURE BPS WITH EQUIPMENT- SINGLE ARCH SVC001624 25400 25400 33100 38100 43200 48300COMPOSITE COSMETIC FILLING - CLASS II SVC001627 900 900 1200 1400 1600 1800COMPOSITE COSMETIC FILLING- CLASS I PIT SVC001628 1300 1300 1700 2000 2300 2500COMPOSITE COSMETIC FILLING MESIO OCCLUSAL DISTAL SVC001629 1300 1300 1700 2000 2300 2500COMPOSITE COSMETIC FILLING-CLASS III/IV/V SVC001630 1600 1600 2100 2400 2800 3100COMPOSITE INLAY SVC001631 12200 12200 15900 18300 20800 23200COMPOSITE RESTORATION SVC001632 2300 2300 3000 3500 4000 4400CORONOPLASTY/TOOTH SVC001927 700 700 1000 1100 1200 1400CROWN ALL CERAMIC /UNIT - EMPRESS SVC001923 13800 13800 18000 20700 23500 26300CROWN CEMENTATION SVC001634 800 800 1100 1200 1400 1600CROWN FULL CERAMIC TYPE-II (PER UNIT) SVC001909 10100 10100 13200 15200 17200 19200CROWN FULL CERAMIC_GST SVC001635 11500 11500 15000 17300 19600 21900CROWN FULL CERAMIC_NON GST SVC001957 10200 10200 13300 15300 17400 19400CROWN LENGHTENING_GST SVC001636 3700 3700 4900 5600 6300 7100CROWN LENGTHNING WITH LASER/TOOTH SVC002166 3500 3500 4600 5300 6000 6700CROWN METAL SVC001637 6400 6400 8400 9600 10900 12200CROWN PORCELAIN FUSED METAL (PFM) SVC001638 7800 7800 10200 11700 13300 14900CROWN PORCELAIN FUSED METAL (PFM) TYPE-II (PER UNIT) SVC001910 7000 7000 9100 10500 11900 13300CROWN PROCERA_GST SVC001639 15600 15600 20300 23400 26600 29700CROWN PROCERA_NON GST SVC001958 18400 18400 24000 27600 31300 35000CROWN REMOVAL SVC001640 600 600 800 900 1100 1200

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteCUSPAL GRINDING PER TOOTH SVC002033 10000 10000 13000 15000 17000 19000

CYST &TUMOUR OF MAXILLA /MANDIBLE BY ENUCLEATION/ EXCISION/MARSUPALISATION SIZE MORE THAN 4 CMS UNDER GA SVC002111 15100 15100 19700 22700 25700 28700

CYST &TUMOUR OF MAXILLA /MANDIBLE BY ENUCLEATION/ EXCISION/MARSUPALISATION SIZE MORE THAN 4 CMS UNDER LA SVC002112 16100 16100 21000 24200 27400 30600CYST &TUMOUR OF MAXILLA /MANDIBLE BY ENUCLEATION/ EXCISION/MARSUPALISATION UPTO 4 CMS UNDER LA SVC002110 26500 26500 34500 39800 45100 50400CYST MANAGEMENT SVC001641 18700 18700 24400 28100 31800 35600CYST MANAGEMENT GRADE IV SVC001842 25300 25300 32900 38000 43100 48100DECIDUOUS TOOTH EXTRACTION SVC001642 1200 1200 1600 1800 2100 2300DENTURE COMPLETE- SINGLE ARCH HIGH STRENGTH SVC001924 104000 104000 135200 156000 176800 197600EXCISION TUMOUR ODONTOGENIC SMALL SVC002113 20700 20700 27000 31100 35200 39400EXPOSURE TOOTH SURGICAL ( LABIAL) SVC002114 700 700 1000 1100 1200 1400EXPOSURE TOOTH SURGICAL ( PALATAL) SVC002115 1800 1800 2400 2700 3100 3500EXTRACTION ERUPTED WISDOM TOOTH SVC001934 4000 4000 5200 6000 6800 7600EXTRACTION ERUPTED WISDOM TOOTH SURGICALY SVC001944 4100 4100 5400 6200 7000 7800EXTRACTION IMPACTED (HORIZONTAL)3RD MOLAR SVC002116 8100 8100 10600 12200 13800 15400EXTRACTION IMPACTED 3RD MOLAR (AT LOWER BORDER OF MANDIBLE) SVC002117 7000 7000 9100 10500 11900 13300EXTRACTION IMPACTED CLASS II 3RD MOLAR SVC002119 8100 8100 10600 12200 13800 15400EXTRACTION IMPACTED CLASS III 3RD MOLAR SVC002120 12800 12800 16700 19200 21800 24400EXTRACTION IMPACTED(DISTOANGULAR) SVC001935 7000 7000 9100 10500 11900 13300EXTRACTION IMPACTED(MESIOANGULAR) SVC001936 5800 5800 7600 8700 9900 11100EXTRACTION OF IMPACTED TOOTH UNDER LA SVC002122 5800 5800 7600 8700 9900 11100EXTRACTION PER TOOTH UNDER LA SVC001937 1800 1800 2400 2700 3100 3500EXTRACTION ROOT STUMP SURGICAL SVC002123 4000 4000 5200 6000 6800 7600FIXED FULL MOUTH - CERAMIC 1ST PAYMENT OF ORTHO T/T SVC002064 27700 27700 36100 41600 47100 52700FIXED FULL MOUTH - CERAMIC 2ND PAYMENT OF ORTHO T/T SVC002065 47400 47400 61700 71100 80600 90100FIXED FULL MOUTH - CERAMIC 3RD PAYMENT OF ORTHO T/T SVC002066 54200 54200 70500 81300 92200 103000FIXED FULL MOUTH - CERAMIC 4TH PAYMENT OF ORTHO T/T SVC002067 92300 92300 120000 138500 157000 175400

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteFIXED FULL MOUTH - CERAMIC 5TH PAYMENT OF ORTHO T/T SVC002068 51900 51900 67500 77900 88300 98700FIXED FULL MOUTH-METAL 1ST PAYMENT OF ORTHO T/T SVC002070 46100 46100 60000 69200 78400 87600FIXED FULL MOUTH-METAL 2ND PAYMENT OF ORTHO T/T SVC002071 3700 3700 4900 5600 6300 7100FIXED FULL MOUTH-METAL 3RD PAYMENT OF ORTHO T/T SVC002072 17300 17300 22500 26000 29500 32900FIXED FULL MOUTH-METAL 4TH PAYMENT OF ORTHO T/T SVC002073 62300 62300 81000 93500 106000 118400FIXED FULL MOUTH-METAL(ORTHODONTIC) SVC002069 68100 68100 88600 102200 115800 129400FIXED PARTIAL DENTURE- (1 UNIT) - CERAMIC SVC001837 5560 7230 8340 9460 10010 10570FIXED PARTIAL DENTURE- (1 UNIT) - METAL SVC001838 8080 10510 12120 13740 14550 15360FLAP SURGERY - PER QUADRANT SVC001652 5600 5600 7300 8400 9600 10700

FLEXIBLE REMOVABLE PARTIAL DENTURE (RPD) - ADDITIONAL TOOTH SVC001654 7000 7000 9100 10500 11900 13300

FLEXIBLE REMOVABLE PARTIAL DENTURE (RPD) - BASE & ONE TOOTH SVC001653 10000 10000 13000 15000 17000 19000FLUORIDE APPLICATION SVC001655 1700 1700 2300 2600 2900 3300FLUORIDE APPLICATION II SVC001856 2800 2800 3700 4200 4800 5400FLUORIDE APPLICATION III SVC001857 1000 1000 1300 1500 1700 1900FRACTURE MANDIBLE(LOCAL ANESTHESIA) SVC001808 11500 11500 15000 17300 19600 21900FRENECTOMY SVC001657 7000 7000 9100 10500 11900 13300FRENECTOMY/FRENOTOMY WITH LASER(LINGUAL) SVC002014 7000 7000 9100 10500 11900 13300FULL DENTURE REPAIR( WITH LAB CHARGES) SVC001868 7800 7800 10200 11700 13300 14900FULL DENTURE- TYPE I U & L SVC001864 23100 23100 30100 34700 39300 43900FULL DENTURE- TYPE II U & L SVC001865 17400 17400 22700 26100 29600 33100FULL DENTURE- TYPE III U & L SVC001866 25300 25300 32900 38000 43100 48100FULL DENTURE- TYPE IV U & L SVC001867 68100 68100 88600 102200 115800 129400GINGIVAL RESHAPING WITH LASER/TOOTH SVC001940 11600 11600 15100 17400 19800 22100GOLD CROWN SVC001664 53100 53100 69100 79700 90300 100900GUM TREATMENT WITH LASER SVC001947 2000 2000 2600 3000 3400 3800GUM TREATMENT WITH LASER/ QUADRANT SVC001948 6400 6400 8400 9600 10900 12200GUM TREATMENT WITH LASER/ TOOTH SVC001949 1800 1800 2400 2700 3100 3500HISTOPATHOLOGY(LAB PROCEDURE FOR BIOPSY) SVC001814 4700 4700 6200 7100 8000 9000HOME BLEACHING_GST SVC001667 5200 5200 6800 7800 8900 9900IMMEDIATE COMPLETE DENTURE SVC001668 16100 16100 21000 24200 27400 30600

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteIMPLANT 1ST PHASE (1) SVC002030 38000 38000 49400 57000 64600 72200IMPLANT 2ND PHASE(2) SVC002031 26500 26500 34500 39800 45100 50400IMPLANT 3RD PHASE(3) SVC002032 32300 32300 42000 48500 55000 61400IMPLANT DENTURE WITH TWO NORMAL ATTACHMENTS SVC001669 24200 24200 31500 36300 41200 46000IMPLANT OVER DENTURE WITH TWO IMPORTED ATTACHMENTS SVC001670 12200 12200 15900 18300 20800 23200IMPLANT TYPE -I SVC001843 30000 30000 39000 45000 51000 57000IMPLANT TYPE -II SVC001844 40200 40200 52300 60300 68400 76400IMPLANT TYPE -III SVC001845 55100 55100 71700 82700 93700 104700IMPLANT WITH BONEGRAFT & MEMBRANE SVC001846 14900 14900 19400 22400 25400 28400IMPORTED COMPLETE DENTURE SVC001672 13900 13900 18100 20900 23700 26500INCISION & DRAINAGE - DENTAL SVC001674 14900 14900 19400 22400 25400 28400INTRA ARTICUAR INJECTION SVC002152 400 400 600 600 700 800INTRA LESIONAL INJECTION IN OSMF /INJ SVC002153 1400 1400 1900 2100 2400 2700INTRA ORAL PERI APICAL (IOPA) RADIOGRAPH - DIGITAL SVC001678 170 230 260 290 310 330LASER - BLEACHING_GST SVC001681 28100 28100 36600 42200 47800 53400LASER - FLAP SURGERY PER QUADRANT SVC001684 9900 9900 12900 14900 16900 18900LASER - FRENECTOMY SVC001685 10400 10400 13600 15600 17700 19800LASER - GINGIVECTOMY SVC001686 2100 2100 2800 3200 3600 4000LASER - OPERCULECTOMY SVC001688 5300 5300 6900 8000 9100 10100LASER DEPIGMENTATION PER TOOTH SVC002169 7000 7000 9100 10500 11900 13300LASER PROCEDURE MAJOR SVC001817 5200 5200 6800 7800 8900 9900LASER STERILIZATION/ROOTH CANAL SVC002170 2300 2300 3000 3500 4000 4400LASER THERAPY FOR APTHOUS AND HERPETIC ULCERS/AREA SVC002171 2900 2900 3800 4400 5000 5600LATERAL CEPHALOGRAM SVC001690 950 1240 1430 1620 1710 1810LEUKOPLAKIA REMOVAL WITH LASER-LARGE SVC002172 8700 8700 11400 13100 14800 16600LEUKOPLAKIA REMOVAL WITH LASER-MEDIUM SVC001942 11600 11600 15100 17400 19800 22100LEUKOPLAKIA REMOVAL WITH LASER-SMALL SVC002173 5800 5800 7600 8700 9900 11100LINGUAL ORTHODONTIC_GST SVC001692 199400 199400 259300 299100 339000 378900LOCAL DRUG DELIVERY SVC001693 1900 1900 2500 2900 3300 3700METAL BASED DENTURE SVC001698 53300 53300 69300 80000 90700 101300METAL FREE CROWN SVC001943 21500 21500 28000 32300 36600 40900METAL FREE CROWN- 3M LAVA ESSENTIAL SVC001963 19800 19800 25800 29700 33700 37700

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteMETAL FREE CROWN- EMAX SVC001964 12200 12200 15900 18300 20800 23200MISCELLANEOUS ORTHODONTICS SVC001821 3800 3800 5000 5700 6500 7300MUCOCOELE REMOVAL WITH LASER SVC002174 2900 2900 3800 4400 5000 5600NORMAL COMPLETE DENTURE SVC001703 28900 28900 37600 43400 49200 55000NORMAL COMPLETE DENTURE - SINGLE ARCH SVC001704 19700 19700 25700 29600 33500 37500NORMAL COMPLETE DENTURE TYPE-I SVC001911 16600 16600 21600 24900 28300 31600NORMAL COMPLETE DENTURE TYPE-II SVC001912 11600 11600 15100 17400 19800 22100OCCLUSAL SPLINT SVC001707 3900 3900 5100 5900 6700 7500ODONTOGENIC CYST ENUCLEATION LARGE SVC002132 49600 49600 64500 74400 84400 94300ODONTOGENIC CYST ENUCLEATION SMALL SVC002133 19600 19600 25500 29400 33400 37300OFFICE BLEACHING SVC001709 10300 10300 13400 15500 17600 19600OFFICE BLEACHING WITH HOME BLEACHING KIT EXTRA BOOST SVC001710 2800 2800 3700 4200 4800 5400OPEN REDUCTION AND INTERNAL FIXATION (ORIF) SVC001914 32300 32300 42000 48500 55000 61400OPERCULECTOMY SVC001711 3500 3500 4600 5300 6000 6700ORTHO PANTO GRAM (OPG) SVC001713 520 680 780 890 940 990ORTHO SINGLE JAW (CERAMIC) SVC001863 80800 80800 105100 121200 137400 153600ORTHO SINGLE JAW (METAL) SVC001862 33400 33400 43500 50100 56800 63500ORTHODONTIC FUNCTIONAL APPLIANCES SVC001716 23000 23000 29900 34500 39100 43700ORTHOPAEDIC APPLIANCES SVC001717 6900 6900 9000 10400 11800 13200PARTIAL FIXED ORTHODONTIC TREATMENT I SVC001860 13800 13800 18000 20700 23500 26300PARTIAL REMOVABLE DENTURE - UNIT SVC001841 29920 38900 44880 50870 53860 56850PEDO CROWN SVC001718 6900 6900 9000 10400 11800 13200PERIODONTAL FLAP SURGERY(FULL MOUTH) SVC002037 12200 12200 15900 18300 20800 23200PIT & FISSURE SEALANT - DECIDUOUS TOOTH SVC001722 800 800 1100 1200 1400 1600PIT & FISSURE SEALANT - PERMANENT TOOTH SVC001723 1300 1300 1700 2000 2300 2500POLYCORBOXYLATE CROWNS SVC001724 1100 1100 1500 1700 1900 2100PORCELAIN FUSED METAL CROWN II SVC001886 5600 5600 7300 8400 9600 10700POSTERIOR CEPHALOGRAM SVC001725 950 1240 1430 1620 1710 1810PRECISION ATTACHMENT WITH TWO CROWNS SVC001726 6100 6100 8000 9200 10400 11600

PRE-PROSTHETIC SURGERY - RIDGE AUGMENTATION (PER QUARANT) SVC002134 8800 8800 11500 13200 15000 16800PULPOTOMY SVC001730 3000 3000 3900 4500 5100 5700

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteRCT - INCISORS SVC001733 3900 3900 5100 5900 6700 7500RCT - MOLARS SVC001734 4700 4700 6200 7100 8000 9000RCT - OPEN APEX SVC001735 2900 2900 3800 4400 5000 5600RCT - POSTERIOR TYPE I SVC001965 7200 7200 9400 10800 12300 13700RCT - POSTERIOR TYPE II SVC001967 5000 5000 6500 7500 8500 9500RCT - POSTERIOR TYPE III SVC001969 7000 7000 9100 10500 11900 13300RCT - POSTERIOR TYPE IV SVC001970 13900 13900 18100 20900 23700 26500RCT - PREMOLARS SVC001736 10900 10900 14200 16400 18600 20800RCT - WISDOM TOOTH SVC001737 3500 3500 4600 5300 6000 6700

REDUCTION & IMMOBILASATION OF FRACTURE-MANDIBLE UNDER LA SVC002137 51900 51900 67500 77900 88300 98700

REDUCTION & IMMOBILASATION OF FRACTURE-MAXILLA UNDER LA SVC002136 17300 17300 22500 26000 29500 32900RELEASE OF FIBROUS BANDS & GRAFTING - IN (OSMF) TREATMENT UNDER GA SVC002138 9000 9000 11700 13500 15300 17100REMOVABALE ORTHODONTIC APPLIANCES SVC001740 6400 6400 8400 9600 10900 12200REMOVABLE ORTHODONTIC RETAINER SVC001741 5000 5000 6500 7500 8500 9500REMOVABLE ORTHODONTICS-FULL PAYMENT SVC002088 6100 6100 8000 9200 10400 11600REMOVABLE ORTHODONTICS-IIND INSTALLMENTS SVC002090 3900 3900 5100 5900 6700 7500REMOVABLE ORTHODONTICS-IST INSTALLMENTS SVC002089 800 800 1100 1200 1400 1600REMOVABLE PARTIAL DENTURE (RPD) ADDITIONAL TOOTH SVC001742 600 600 800 900 1100 1200REMOVABLE PARTIAL DENTURE (RPD) PER TOOTH SVC001743 800 800 1100 1200 1400 1600REMOVABLE PARTIAL DENTURE- METAL BASED FOR EVERY SINGLE TEETH AFTER 3 TEETH SVC001956 1200 1200 1600 1800 2100 2300

REMOVABLE PARTIAL DENTURE-ACRYLIC BASED-MORE THAN 3 TEETH SVC002018 1800 1800 2400 2700 3100 3500RE-RCT- INCISORS SVC001745 7000 7000 9100 10500 11900 13300RE-RCT-MOLARS SVC001746 7800 7800 10200 11700 13300 14900RE-RCT-PREMOLARS SVC001747 6000 6000 7800 9000 10200 11400RESTORATION COMPOMER/GIOMER SVC002048 900 900 1200 1400 1600 1800RESTORATION GIC II SURFACE SVC002050 1800 1800 2400 2700 3100 3500RESTORATION LIGHT CURE COMPOSITE I SURFACE SVC002051 2300 2300 3000 3500 4000 4400

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteRESTORATION LIGHT CURE COMPOSITE II SURFACE SVC002052 2400 2400 3200 3600 4100 4600RESTORATION LIGHT CURE GIC (CERVICAL) SVC002006 2100 2100 2800 3200 3600 4000RESTORATION LIGHT CURE GIC CORE BUILD UP SVC002053 2200 2200 2900 3300 3800 4200RESTORATION MIRACLEMIX I SURFACE SVC002015 1600 1600 2100 2400 2800 3100RESTORATION MIRACLEMIX II SURFACE SVC002016 2000 2000 2600 3000 3400 3800ROOT CANAL TREATMENT (RCT) ANTERIOR TEETH SVC001919 6300 6300 8200 9500 10800 12000ROOT CANAL TREATMENT (RCT) POSTERIOR TEETH SVC001920 7600 7600 9900 11400 13000 14500ROOT CANAL TREATMENT(RCT)ROTARY SVC001930 7400 7400 9700 11100 12600 14100SCALING & POLISHING TYPE I SVC001896 1900 1900 2500 2900 3300 3700SCALING & POLISHING TYPE II SVC001897 1800 1800 2400 2700 3100 3500SCALING AND POLISHING ADDITIONAL SITTING SVC001971 500 500 700 800 900 1000SEMI RIGID PARTIAL DENTURE - SUN FLEX SVC001754 7100 7100 9300 10700 12100 13500SEMI RIGID PARTIAL DENTURE - SUN FLEX - ADDITIONAL TOOTH SVC001755 1300 1300 1700 2000 2300 2500SINGLE DENTURE REPAIR( MINOR) SVC001873 5900 5900 7700 8900 10100 11300SINGLE DENTURE REPAIR( WITH LAB CHARGES) SVC001874 5200 5200 6800 7800 8900 9900SINGLE DENTURE- TYPE I SVC001869 12600 12600 16400 18900 21500 24000SINGLE DENTURE- TYPE II SVC001870 19000 19000 24700 28500 32300 36100SINGLE DENTURE- TYPE III SVC001871 19000 19000 24700 28500 32300 36100SINGLE TOOTH IMPLANT SVC001759 34600 34600 45000 51900 58900 65800SINUS LIFT SVC001760 25300 25300 32900 38000 43100 48100SINUSLIFT II SVC001847 42700 42700 55600 64100 72600 81200SOCKET DRESSING (DENTAL)/VISIT SVC002156 2900 2900 3800 4400 5000 5600SPLINT SVC001950 3400 3400 4500 5100 5800 6500SPLINTS (6 ANTERIORS) SVC001980 2800 2800 3700 4200 4800 5400STAINLESS STEEL CROWN SVC001830 4800 4800 6300 7200 8200 9200STAINLESS STEEL CROWN FOR PEDIATRIC II SVC001853 3500 3500 4600 5300 6000 6700STAINLESS STEEL CROWN FOR PEDIATRIC III SVC001854 3500 3500 4600 5300 6000 6700STRAIGHT WIRE ORTHODONTIC- METAL BRACES TYPE-I SVC001901 31100 31100 40500 46700 52900 59100STRAIGHT WIRE ORTHODONTIC- METAL BRACES TYPE-II SVC001902 49600 49600 64500 74400 84400 94300STRAIGHT WIRE ORTHODONTICS -CERAMIC BRACES SVC001765 27700 27700 36100 41600 47100 52700STRAIGHT WIRE ORTHODONTICS -CERAMIC BRACES TYPE-I SVC001903 103900 103900 135100 155900 176700 197500STRAIGHT WIRE ORTHODONTICS -CERAMIC BRACES TYPE-II SVC001904 69200 69200 90000 103800 117700 131500

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteSTRIP CROWN SVC001766 2300 2300 3000 3500 4000 4400STUDY MODEL SVC001767 700 700 1000 1100 1200 1400SUBGINGIVAL CURETTAGE SVC001768 3500 3500 4600 5300 6000 6700SUPER SPLINT SVC001770 4700 4700 6200 7100 8000 9000SUPRA GINGIVAL SCALING AND POLISHING SVC001771 800 800 1100 1200 1400 1600SUTURE REMOVAL SVC001774 700 700 1000 1100 1200 1400TEMPORARY CROWN SVC001776 7000 7000 9100 10500 11900 13300TEMPORARY DENTURE SVC001777 13600 13600 17700 20400 23200 25900TEMPORARY FILLING SVC001778 600 600 800 900 1100 1200TEMPORO MANDIBULAR JOINT DISLOCATION MANAGEMENT SVC001833 1200 1200 1600 1800 2100 2300TITANIUM CAST PARTIAL DENTURE SVC001782 68100 68100 88600 102200 115800 129400TOOTH ADDITION IN A DENTURE/TOOTH SVC002028 1300 1300 1700 2000 2300 2500TOOTH BLEACHING WITH LASER PER QUADRANT SVC002178 19700 19700 25700 29600 33500 37500TRANSITIONAL IMPLANT SVC001788 49600 49600 64500 74400 84400 94300VESTIBULOPLASTY SVC001789 9500 9500 12400 14300 16200 18100ZIRCONIA CROWN_GST SVC001791 19800 19800 25800 29700 33700 37700ZIRCONIA CROWN_NON GST SVC001959 17900 17900 23300 26900 30500 34100

ACNE THERAPY_GST SVC001590 2200 2200 2900 3300 3800 4200CHEMICAL PEEL_GST SVC001576 3100 3100 4100 4700 5300 5900CRYOTHERAPY_GST SVC001588 1600 1600 2100 2400 2800 3100ELECTRO CAUTERY / RADIOFREQUENCY (2 - 5 LESIONS)_GST SVC001577 4600 4600 6000 6900 7900 8800ELECTRO CAUTERY / RADIOFREQUENCY (5 - 20 LESIONS)_GST SVC001578 5700 5700 7500 8600 9700 10900ELECTRO CAUTERY / RADIOFREQUENCY (SINGLE LESION)_GST SVC001579 800 800 1100 1200 1400 1600INTRALESIONAL INJECTION (PER INJECTION) FOR KELOIDS SVC001580 1000 1000 1300 1500 1700 1900MOLLUSCUM CURETTAGE (2 - 5 LESIONS)_GST SVC001581 4100 4100 5400 6200 7000 7800MOLLUSCUM CURETTAGE (5 - 20 LESIONS)_GST SVC001582 4400 4400 5800 6600 7500 8400MOLLUSCUM CURETTAGE (SINGLE LESION)_GST SVC001583 800 800 1100 1200 1400 1600PATCH TEST SVC001584 3100 3100 4100 4700 5300 5900PRICK TEST FOR FOOD PROFILE SVC001586 13900 13900 18100 20900 23700 26500SKIN BIOPSY SVC001585 1800 1800 2400 2700 3100 3500

Dermetology

ENT

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteEAR LOBE REPAIR - BOTH SIDES_GST SVC002205 3000 3000 3900 4500 5100 5700EAR LOBE REPAIR - ONE SIDE_GST SVC002206 2000 2000 2600 3000 3400 3800NASAL ENDOSCOPY (DIAGNOSTIC) SVC002207 2500 2500 3250 3750 4250 4750VIDEOLARYNGOSCOPY SVC002209 2500 2500 3250 3750 4250 4750CORTICAL MASTOIDECTOMY SVC002211 45000 58500 67500 76500 85500DIRECT LARYNGOSCOPY SVC002212 5000 6500 7500 8500 9500ENDOSCOPIC EXCISION OF RHINOSPORIDIOSIS SVC002213 30000 39000 45000 51000 57000ENDOSCOPIC FUNGAL SINUSITIS CLEARANCE SVC002214 60000 78000 90000 102000 114000ENDOSCOPIC MASTOIDECTOMY SVC002215 43400 56500 65100 73800 82500ENDOSCOPIC MEDIAL MAXILLECTOMY SVC002216 60000 78000 90000 102000 114000ENDOSCOPIC NASAL CAUTERISATION SVC002217 5000 6500 7500 8500 9500ENDOSCOPIC OPTIC NERVE DECOMPRESSION SVC002218 43400 56500 65100 73800 82500ENDOSCOPIC OSSICULOPLASTY SVC002219 60000 78000 90000 102000 114000ENDOSCOPIC SEPTAL CORRECTION SVC002220 50000 65000 75000 85000 95000ENDOSCOPIC SPHENOIDOTOMY SVC002221 45000 58500 67500 76500 85500ENDOSCOPIC STAPEDECTOMY SVC002222 50000 65000 75000 85000 95000ENDOSCOPIC TYMPANOPLASTY SVC002223 26700 34800 40100 45400 50800ENDOSCOPIC TURBINECTOMY/TURBINOPLASTY SVC002224 25000 32500 37500 42500 47500MICROLARYNGEAL SURGERY SVC002225 35000 45500 52500 59500 66500PREAURICULAR SINUS EXCISION (BILATERAL) SVC002226 35000 45500 52500 59500 66500PREAURICULAR SINUS EXCISION (UNILATERAL) SVC002227 13400 17500 20100 22800 25500RADICAL MASTOIDECTOMY SVC002228 43400 56500 65100 73800 82500RADICAL MODIFIED MASTOIDECTOMY SVC002229 44700 58200 67100 76000 85000RHINOLITH REMOVAL SVC002230 4700 6200 7100 8000 9000SEPTAL HAEMATOMA DRAINAGE SVC002231 8000 10400 12000 13600 15200SURGICAL TREATMENT OF LARYNGOFISSURE SVC002232 20000 26000 30000 34000 38000TONSILLECTOMY SVC002233 26700 34800 40100 45400 50800TRANS NASAL TRANS SPHENOIDAL HYPOPHYSECTOMY SVC002234 80000 104000 120000 136000 152000TYMPANOPLASTY WITH CORTICAL MASTOIDECTOMY SVC002235 50000 65000 75000 85000 95000UVULO - PALATO PHARYNGOPLASTY SVC002236 33400 43500 50100 56800 63500AURAL POLYP EXCISION SVC002237 2000 2000 2600 3000 3400 3800THERAPY FOR HEARING IMPAIRED SVC002238 1500 1500 1950 2250 2550 2850

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteDEEP NECK ABSCESS EXPLORATION AND DRAINAGE SVC002239 30000 39000 45000 51000 57000FUNCTIONAL ENDOSCOPIC SINUS SURGERY (FESS) SVC002240 30000 39000 45000 51000 57000ENDOSCOPIC ASSISTED POLYPECTOMY SVC002241 25000 32500 37500 42500 47500ENDOSCOPIC ORBITAL DECOMPRESSION SVC002242 40000 52000 60000 68000 76000TRACHEAL T-TUBE PLACEMENT SVC002243 20000 26000 30000 34000 38000SUB MUCUS RESECTION OF SEPTUM SVC002244 25000 32500 37500 42500 47500ADENOIDECTOMY SVC002245 16700 21800 25100 28400 31800FRACTURE NASAL BONES SVC002246 20000 26000 30000 34000 38000RESECTION OF TRACHEAL STENOSIS SVC002247 75000 97500 112500 127500 142500PARAPHARYNGEAL TUMOUR EXCISION SVC002248 65000 84500 97500 110500 123500NASAL PACK REMOVAL SVC002249 1000 1000 1300 1500 1700 1900NASAL ENDOSCOPY (BIOPSY / CAUTERIZATION) SVC002250 10000 13000 15000 17000 19000CALDWELL LUC SURGERY SVC002251 20000 26000 30000 34000 38000ADENOTONSILLECTOMY SVC002252 33400 43500 50100 56800 63500ENDOSCOPIC EXCISION OF NASAL MASS SVC002253 40000 52000 60000 68000 76000NASAL PACKING FOR EPISTAXIS SVC002254 3000 3000 3900 4500 5100 5700SUBMUCOSAL NASAL DIATHERMY SVC002255 15000 19500 22500 25500 28500ENDOSCOPIC REMOVAL OF FOREIGN BODY SVC002257 7000 7000 9100 10500 11900 13300MYRINGOTOMY WITH GROMMET INSERTION SVC002263 6700 8800 10100 11400 12800NASAL MASS EXCISION - LATERAL RHINOTOMY SVC002264 26700 34800 40100 45400 50800CANAL PLASTY (CORTICAL MASTOIDECTOMY) SVC002265 45000 58500 67500 76500 85500EXCISION OF ADENOMA (TAIL OF PAROTID) SVC002266 50000 65000 75000 85000 95000

RECANALISATION OF BOTH THE NASAL CAVITIES (CHOANAL ATRESIA) SVC002267 40000 52000 60000 68000 76000EXCISION OF KELOID EAR LOBE AND FLAP RECONSTRUCTION SVC002268 25000 32500 37500 42500 47500FOREIGN BODY REMOVAL - THROAT SVC002269 15000 19500 22500 25500 28500INCISION AND DRAINAGE -EAR HAEMATOMA(OPP) SVC002270 5000 5000 6500 7500 8500 9500INCISION AND DRAINAGE -NECK ABSCESS(OPP) SVC002271 5000 5000 6500 7500 8500 9500KELOID EXCISION - PINNA(OPP) SVC002272 7000 7000 9100 10500 11900 13300LYMPH NODE BIOPSY - NECK(OPP) SVC002273 7000 7000 9100 10500 11900 13300NASAL CAUTERIZATION(OPP) SVC002274 4000 4000 5200 6000 6800 7600FOREIGN BODY REMOVAL - EAR (OPP) SVC002275 2000 2600 3000 3400 3800

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteFOREIGN BODY REMOVAL - NOSE (OPP) SVC002276 3400 4500 5100 5800 6500FOREIGN BODY REMOVAL - THROAT (OPP) SVC002277 4400 5800 6600 7500 8400KELOID EXCISION - PINNA SVC002278 5000 6500 7500 8500 9500INCISION AND DRAINAGE -EAR HAEMATOMA SVC002279 5400 7100 8100 9200 10300INCISION AND DRAINAGE -NECK ABSCESS SVC002280 10000 13000 15000 17000 19000LYMPH NODE BIOPSY - NECK SVC002281 15000 19500 22500 25500 28500NASAL CAUTERIZATION SVC002282 4700 6200 7100 8000 9000FACIAL NERVE DECOMPRESSION SVC002283 40000 52000 60000 68000 76000TRACHEOPLASTY SVC002284 75000 97500 112500 127500 142500ENDOSCOPIC DACROCYSTORHINOSTOMY (DCR) SVC002285 20000 26000 30000 34000 38000CSF OTORRHOEA CLOSURE SVC002286 26700 34800 40100 45400 50800ENDOSCOPIC CSF CLOSURE SVC002287 40000 52000 60000 68000 76000SUBGLOTTIC STENOSIS- LASER EXCISION AND STENTING SVC002288 75000 97500 112500 127500 142500FOREIGN BODY REMOVAL - EAR SVC002289 3400 4500 5100 5800 6500FOREIGN BODY REMOVAL - NOSE SVC002290 8000 8000 10400 12000 13600 15200COCHLEAR IMPLANTATION SVC002291 100000 130000 150000 170000 190000EPLEY MANEUVER SVC002292 1500 1500 1950 2250 2550 2850EXCISION OF RANULA SVC002293 13400 17500 20100 22800 25500BRACHIAL FISTULECTOMY SVC002294 20000 26000 30000 34000 38000OTOACOUSTIC EMISSIONS (OAE) SVC002295 1100 1100 1430 1650 1870 2090CAROTID SINUS MASSAGE SVC002296 15000 19500 22500 25500 28500SYRINGING OF EAR (ONE SIDE) SVC002297 1000 1000 1300 1500 1700 1900SUCTIONING OF EAR SVC002298 1000 1000 1300 1500 1700 1900TRANSPALATAL EXCISION OF JUVENILE NASOPHARYNGEAL ANGIOFIBROMA (JNA) SVC002299 60000 78000 90000 102000 114000ENDOSCOPIC EXCISION OF JUVENILE NASOPHARYNGEAL ANGIOFIBROMA (JNA) SVC002300 70000 91000 105000 119000 133000OTIMICROSCOPY SVC002301 2500 2500 3250 3750 4250 4750DARO CYSTO RHINOSTOMY SVC002302 30000 39000 45000 51000 57000T TUBE REMOVAL SVC002303 5000 5000 6500 7500 8500 9500SPEECH RECEPTION THRESHOLD SVC002304 2500 2500 3250 3750 4250 4750TELELARYNGOSCOPY SVC002305 4500 4500 5850 6750 7650 8550

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteLATERALISATION OF VOCAL CORD SVC002306 40000 52000 60000 68000 76000CORDECTOMY SVC002307 35000 45500 52500 59500 66500EAR PIERCING WITH GUN (SINGLE)_GST SVC002308 1500 1500 1950 2250 2550 2850EAR PIERCING WITH GUN (BOTH)_GST SVC002309 3100 3100 4030 4650 5270 5890OTOENDOSCOPY SVC002310 2000 2000 2600 3000 3400 3800EAR WAX REMOVAL U/L SVC002311 1000 1000 1300 1500 1700 1900

FIBEROPTIC ENDOSCOPIC EVALUATION OF SWALLOWING (FEES) SVC002312 7000 7000 9100 10500 11900 13300I & D - PERITONSILLAR ABSCESS SVC002313 4000 4000 5200 6000 6800 7600ETHMOIDECTOMY - EXTERNAL SVC002314 20000 26000 30000 34000 38000CYSTIC HYGROMA EXCSION SVC002315 25000 32500 37500 42500 47500THYROPLASTY TYPE 1 SVC002316 25000 32500 37500 42500 47500RETROPHARYNGEAL ABSCESS DRAINAGE - INTRAORAL SVC002317 10000 13000 15000 17000 19000THYROGLOSSAL CYST EXCISION SVC002318 23400 30500 35100 39800 44500BRANCHIAL FISTULA / CYST EXCISION SVC002319 23400 30500 35100 39800 44500INTRATYMPANIC GENTAMICIN INJECTION SVC002320 2500 2500 3250 3750 4250 4750GROMMET INSERTION - UNILATERAL SVC002321 4000 4000 5200 6000 6800 7600GROMMET INSERTION - BILATERAL SVC002322 8000 8000 10400 12000 13600 15200DIRECT LARYNGOSCOPY AND BIOPSY SVC002323 10000 13000 15000 17000 19000EXPLORATORY TYMPANOTOMY SVC002324 26700 34800 40100 45400 50800NOSE PIERCING_GST SVC002325 2000 2000 2600 3000 3400 3800EXTENDED PARTIAL CRICOTRACHEAL RESECTION (EPCTR) SVC002326 80000 104000 120000 136000 152000VIDEO LARYNGOSCOPY WITH BIOPSY SVC002327 15000 19500 22500 25500 28500LASER POST CORDOTOMY SVC002328 25000 32500 37500 42500 47500BONE ANCHORED HEARING AID (BAHA) WITHOUT DIAGNOSTIC SVC002329 2500 2500 3250 3750 4250 4750ADENOIDECTOMY+GROMMET INSERTION - BILATERAL SVC002330 35000 45500 52500 59500 66500BERA/AEP (BRAIN STEM AUDITORY EVOKED POTENTIALS SVC002331 4500 4500 5850 6750 7650 8550PALATOPHARYNGOPLASTY SVC002332 26000 33800 39000 44200 49400ADENOIDECTOMY WITH BIL.GROMMET SVC002333 35000 45500 52500 59500 66500MASTOIDECTOMY WITH TYMPANOPLASTY SVC002334 45000 58500 67500 76500 85500MYRINGOPLASTY SVC002335 16700 21800 25100 28400 31800MYRINGOTOMY SVC002336 8000 8000 10400 12000 13600 15200

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteNASAL WASH WITH SALINE SVC002337 1500 1500 1950 2250 2550 2850TYMPANOPLASTY WITH CORTICAL MASTOIDECTOMY WITH OSSICULOPLASTY SVC002338 50000 65000 75000 85000 95000MICRO-LARYNGEAL SURGERY - INTERMEDIATE SVC002340 25000 32500 37500 42500 47500RIGID BRONCHOSCOPY - MINOR SVC002341 7000 9100 10500 11900 13300RIGID BRONCHOSCOPY - MAJOR SVC002342 10000 13000 15000 17000 19000SUBMANDIBULAR GLAND EXCISION SVC002343 20000 26000 30000 34000 38000INCISION AND DRAINAGE - MAJOR SVC002344 20000 26000 30000 34000 38000COCHLEAR IMPLANT SVC002345 66700 86800 100100 113400 126800IMP AUDIOMETRY SVC002346 1500 1500 1950 2250 2550 2850ENDOSCOPIC MICRODRIBDER WITH COBLATION ASSISTED ADENOIDECTOMY SVC002347 30000 39000 45000 51000 57000HEARING AID ANALYSIS SVC002348 2000 2000 2600 3000 3400 3800SLEEP ENDOSCOPY SVC002349 12000 15600 18000 20400 22800COMBINED MANDIBULECTOMY AND NECK DISSECTION OPERATION(COMMANDO) SVC002350 60000 78000 90000 102000 114000ENDOSCOPIC SEPTOTURBINOPLASTY SVC002351 40000 52000 60000 68000 76000EXTENDED ENDOSCOPIC ENDONASAL APPROACH TO TUMOURS SVC002352 45000 58500 67500 76500 85500MICROLARYNGOSCOPY BIOPSY SVC002353 23400 30500 35100 39800 44500SUPERFICIAL PAROTIDECTOMY WITH NERVE MONITORING SVC002354 40000 52000 60000 68000 76000MICROLARYNGOSCOPIC SURGERIES BY LASER BILATERAL SVC002355 40000 52000 60000 68000 76000MASTOIDECTOMY SVC002356 40000 52000 60000 68000 76000SKULL BASE SURGERY MAJOR SVC002357 75000 97500 112500 127500 142500SKULL BASE RECONSTRUCTION SVC002358 40000 52000 60000 68000 76000GLOMUS TUMOR EXCISION SVC002359 36700 47800 55100 62400 69800SUPERFICIAL PAROTIDECTOMY WITH WIDE EXCISION SVC002360 40000 52000 60000 68000 76000ARCH BAR+DENTAL WINGS SVC002361 20000 26000 30000 34000 38000SPHENOPALATINE ARTERY LIGATION(SPA LIGATION) SVC002362 25000 32500 37500 42500 47500EXCISION OF B/L VOCAL CORD MASS SVC002363 30000 39000 45000 51000 57000ATTIC RECONSTRUCTION SVC002364 45000 58500 67500 76500 85500FUNGAL FESS SVC002365 55000 71500 82500 93500 104500ENDOSCOPIC SEPTOPLASTY SVC002385 45000 58500 67500 76500 85500

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteFOB FOREIGN BODY REMOVAL SVC008284 8000 8000 10400 12000 13600 15200FIBRE OPTIC LARYNGOSCOPY DIAGNOSTIC SVC011952 5000 5000 6500 7500 8500 9500ENDOSCOPIC SEPTOTURBINOPLASTY WITH FESS SVC013429 65000 84500 97500 110500 123500Full House FESS SVC013560 40000 52000 60000 68000 76000

ACHALASIA DILATATION PKG PKG003913 12200 15900 18300 20800 23200APC PKG PKG014741 11000 14300 16500 18700 20900ARGON PLASMA COAGULATION (APC) SVC002945 9300 9300 12100 14000 15900 17700CAPSULE ENDOSCOPY SVC002817 18000 18000 23400 27000 30600 34200CHOLECYSTECTOMY & EXPLORATION + REPAIR OF COMMON BILE DUCT SVC002977 32400 42200 48600 55100 61600CHROMOENDOSCOPY SVC002856 5400 5400 7100 8100 9200 10300COLONOSCOPY AHD PKG PKG003910 9200 12000 13800 15700 17500COLONOSCOPY WITH ARGON PLASMA COAGULATION PKG PKG006446 13900 18100 20900 23700 26500COLONOSCOPY WITH SCLEROTHERAPY SVC012932 9450 12290 14180 16070 17010 17960DIAGNOSTIC PARACENTESIS SVC002970 2400 2400 3200 3600 4100 4600ENDOLOOP APPLICATION SVC002826 3500 3500 4600 5300 6000 6700ENDOSCOPIC (GASTRO) FOREIGN BODY REMOVAL PKG PKG006447 12100 15800 18200 20600 23000ENDOSCOPIC BALLOON DILATATION SVC002819 9900 12900 14900 16900 18900ENDOSCOPIC BALLOON DILATATION - SUBSEQUENT SESSION WITHIN 1 MONTH PKG PKG014735 8700 11400 13100 14800 16600ENDOSCOPIC BALLOON DILATATION PKG PKG014739 11600 15100 17400 19800 22100ENDOSCOPIC BIOPSY SVC002884 800 800 1100 1200 1400 1600ENDOSCOPIC CLIP APPLICATION SVC002829 3500 4600 5300 6000 6700ENDOSCOPIC FEEDING TUBE PLACEMENT SVC002830 6800 8900 10200 11600 13000ENDOSCOPIC GLUE INJECTION SVC002820 22100 28800 33200 37600 42000ENDOSCOPIC PLACEMENT OF INTRAGASTRIC BALLOON.PKG PKG014742 11600 15100 17400 19800 22100ENDOSCOPIC POLYPECTOMY - MULTIPLE SVC002861 15100 19700 22700 25700 28700ENDOSCOPIC PSEUDOCYST DRAINAGE SVC002833 22900 29800 34400 39000 43600ENDOSCOPIC VARICEAL LIGATION - SUBSEQUENT SESSION WITHIN 1 MONTH SVC002834 6300 6300 8200 9500 10800 12000ENDOSCOPY (BED SIDE) SVC002968 3200 3200 4200 4800 5500 6100

Gastroenterology

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteENDOSCOPY THERAPEUTIC SCLEROTHERAPY SVC002492 9500 9500 12400 14300 16200 18100ENTERAL STENTING PKG PKG014736 20800 27100 31200 35400 39600ENTEROSCOPY PKG PKG006424 9300 12100 14000 15900 17700ERCP - DIAGNOSTIC PKG PKG006425 18000 23400 27000 30600 34200ERCP + BILIARY STENTING SVC002838 20000 26000 30000 34000 38000ERCP + BILIARY STENTING + STONE REMOVAL PKG PKG014732 28000 36400 42000 47600 53200ERCP + BILIARY STENTING PKG PKG014731 23100 30100 34700 39300 43900ERCP + PANCREATIC STENTING PKG PKG014737 23100 30100 34700 39300 43900ERCP + SPHINCTEROTOMY SVC002840 18300 23800 27500 31200 34800ERCP + STONE REMOVAL - WITH LITHOTRIPSY PKG PKG014729 29200 38000 43800 49700 55500ERCP + STONE REMOVAL - WITHOUT LITHOTRIPSY SVC002841 19600 25500 29400 33400 37300ERCP SPHINCTEROTROMY _PKG PKG006430 21400 27900 32100 36400 40700ERCP SPHINCTEROTROMY BALOON SWEEP_PKG PKG003923 23100 30100 34700 39300 43900ERCP STENT REMOVAL_PKG PKG003924 21600 28100 32400 36800 41100ESOPHAGEAL BRUSH CYTOLOGY SVC003039 1800 1800 2400 2700 3100 3500ESOPHAGEAL STENTING SVC002844 20800 27100 31200 35400 39600

EUS (ENDOSCOPIC ULTRASOUND) GUIDED FNA OF PANCREATIC MASS SVC002937 15900 20700 23900 27100 30300EVL (ENDOSCOPIC VARICEAL LIGATION) SVC002845 9500 12400 14300 16200 18100GASTROSCOPY SVC002901 7400 9700 11100 12600 14100GASTROSCOPY WITH BIOPSY SVC002902 9500 9500 12400 14300 16200 18100HEPATIC VENOUS PRESSURE GRADIENT (HVPG) SVC002919 9300 12100 14000 15900 17700LARGE VOLUME PARACENTESIS SVC002896 4700 6200 7100 8000 9000LIVER BIOPSY - PERCUTANEOUS PKG PKG006442 7600 7600 9900 11400 13000 14500LOOP COLOSTOMY SVC002889 24400 31800 36600 41500 46400OESOPHAGEAL DILATATION - BOUGIE PKG PKG014738 10400 13600 15600 17700 19800

OESOPHAGO GASTRO DUODENOSCOPY (ENDOSCOPY) AHD PKG PKG003919 6400 8400 9600 10900 12200

PEG (PERCUTANEOUS ENDOSCOPIC GASTROSTOMY) TUBE REMOVAL SVC002946 4200 4200 5500 6300 7200 8000PEG BUTTON / PEG BALLOON PLACEMENT PKG PKG014734 10400 13600 15600 17700 19800PERCUTANEOUS ENDOSCOPIC GASTROTOMY REMOVAL SVC002874 3500 3500 4600 5300 6000 6700

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuitePERCUTANEOUS ENDOSCOPIC JEJUNOSTOMY SVC002850 13200 17200 19800 22500 25100PILES BANDING SVC002929 1600 1600 2100 2400 2800 3100POLYPECTOMY SVC002822 4100 4100 5400 6200 7000 7800PROCTOSCOPY SVC002906 1900 1900 2500 2900 3300 3700PUSH ENTEROSCOPY SVC002875 6900 6900 9000 10400 11800 13200PYLORIC DILATATION (FIRST SESSION) SVC002851 6400 6400 8400 9600 10900 12200RADICAL HEMICOLECTOMY SVC002903 48600 63200 72900 82700 92400SENGSTAKEN TUBE INSERTION SVC002853 8700 8700 11400 13100 14800 16600SIDE VIEWING ENDOSCOPY PKG PKG014733 9900 12900 14900 16900 18900SIGMOIDOSCOPY AHD PKG PKG003911 6400 8400 9600 10900 12200THERAPEUTIC ENDOSCOPY PKG PKG014740 8100 10600 12200 13800 15400UMBILICAL HERNIOPLASTY SVC002897 19700 25700 29600 33500 37500BILIARY BALLOON DILATATION_PKG PKG006423 58000 75400 87000 98600 110200BILIARY STONE EXTRACTION_PKG PKG006666 75600 98300 113400 128600 143700METALLIC BILIARY STENTING SVC003314 17400 22700 26100 29600 33100METALLIC BILIARY STENTING PKG PKG004102 61000 79300 91500 103700 115900LARRY TUBE/LARRY BUTTON INSERTION SVC013354 1100 1100 1500 1700 1900 2100

ABDOMINO PERINEAL RESECTION SVC002598 33600 43700 50400 57200 63900ABDOMINOPLASTY_GST SVC002588 41200 53600 61800 70100 78300ABSCESS DRAINAGE SUB-DIAPRAGMAPHIC/SUB-HEPATIC SVC002663 15800 20600 23700 26900 30100ADHESIOLYSIS LAPAROSCOPIC SVC002551 18000 23400 27000 30600 34200ANTERIOR RESECTION (OPEN) SVC002407 41600 54100 62400 70800 79100APPENDICULAR ABSCESS DRAINAGE SVC002670 10500 13700 15800 17900 20000BURST ABDOMEN/LAPAROTOMY WOUND RESUTURING SVC002552 15800 20600 23700 26900 30100CAPD CATHETER INSERTION SVC002408 16800 21900 25200 28600 32000CHOLECYSTECTOMY WITH CHOLEDOCHODUODENOSTOMY SVC002513 23100 30100 34700 39300 43900

CHOLEDOCHAL CYST EXCISION WITH HEPATICOJEJUNOSTOMY (OPEN) SVC002411 34700 45200 52100 59000 66000CHOLEDOCHODUODENOSTOMY SVC002476 26300 34200 39500 44800 50000CLOSURE OF CHOLECYSTO-DUAODENAL FISTULA SVC002811 25200 32800 37800 42900 47900CLOSURE OF HOLLOW VISCUS PERFORATION SVC002727 25200 32800 37800 42900 47900

General Surgery

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteCOLONOSCOPY POLYPECTOMY SVC002489 12200 15900 18300 20800 23200COMMON BILE DUCT (CBD) EXPLORATION SVC002532 24900 32400 37400 42400 47400COMMON BILE DUCT REPAIR SVC002651 33600 43700 50400 57200 63900CYSTOGASTROSTOMY/CYSTOJEJUNOSTOMY(LAPAROSCOPIC) SVC002556 31500 41000 47300 53600 59900CYSTOGASTROSTOMY/CYSTOJEJUNOSTOMY(OPEN) SVC002505 23100 30100 34700 39300 43900DEBULKING OF TUMOUR SVC002563 52500 68300 78800 89300 99800DEEP SUTURING SVC002498 1600 1600 2100 2400 2800 3100DEEP WOUND DEBRRIDEMENT SVC002499 9000 9000 11700 13500 15300 17100DIAGNOSTIC ENDOSCOPIC ULTRASOUND SVC002602 18400 24000 27600 31300 35000DIAGNOSTIC LAPAROSCOPY SVC002538 20800 27100 31200 35400 39600DIAPHRAGMATIC HERNIA REPAIR(OPEN) SVC002506 22100 28800 33200 37600 42000DISTAL /TOTAL GASTRECTOMY SVC002584 31500 41000 47300 53600 59900DIVERSION TRANSVERSE COLOSTOMY SVC002496 28100 36600 42200 47800 53400DRAINAGE OF PERIANAL ABSCESS SVC002526 7900 10300 11900 13500 15100ENUCLEATION OF BENIGN PANCREATIC NEOPLASM / CYST SVC002414 31500 41000 47300 53600 59900EUS DIAGNOSTIC SVC003025 7200 7200 9400 10800 12300 13700EXCISION OF CORN - MULTIPLE SVC002578 2100 2100 2800 3200 3600 4000EXCISION OF CORN- SINGLE SVC002605 3500 3500 4600 5300 6000 6700EXCISION OF MESENTERIC MASS (OPEN) SVC002415 15800 20600 23700 26900 30100EXCISION OF SEBACEOUS CYST SVC002416 4900 6400 7400 8400 9400EXPLORATORY LAPAROTOMY (LIVER TRAUMA) SVC002543 25200 32800 37800 42900 47900EXPLORATORY LAPAROTOMY WITH LAVAGE SVC002553 22200 28900 33300 37800 42200EXTRAPERITONEAL DRAINAGE OF PSOAS ABSCESS / RETROPERITONEAL ABSCESS SVC002417 16200 21100 24300 27600 30800FISSURECTOMY SVC002614 15600 20300 23400 26600 29700FISTULA IN ANO-HIGH LEVEL SVC002657 15800 20600 23700 26900 30100FISTULECTOMY (LOW) SVC002537 12600 16400 18900 21500 24000FISTULOTOMY WITH SETON PLACEMENT (HIGH) SVC002419 23100 30100 34700 39300 43900FOURNIER GANGRENE SVC002609 17900 23300 26900 30500 34100FUNDOPLICATION(LAPAROSCOPIC) SVC002545 29400 38300 44100 50000 55900FUNDOPLICATION(OPEN) SVC002507 29400 38300 44100 50000 55900GASTRO JEJUNOSTOMY + VAGOTOMY (OPEN) SVC002421 27300 35500 41000 46500 51900

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteGASTROJEJUNOSTOMY LAPAROSCOPIC SVC002548 26300 34200 39500 44800 50000GASTROJEJUNOSTOMY OPEN SVC002547 21000 27300 31500 35700 39900HAEMORROIDECTOMY/ PILES SVC002567 18900 24600 28400 32200 36000HAEMORROIDECTOMY/ PILES PKG PKG006391 60400 78600 90600 102700 114800HEMORRHOIDS BANDING SVC002520 3700 4900 5600 6300 7100HEPATECTOMY SVC002423 40500 52700 60800 68900 77000HEPATICOJEJUNOSTOMY SVC002494 29400 38300 44100 50000 55900HERNIOTOMY-OPEN/LAP SVC002665 12600 16400 18900 21500 24000HILAR CHOLANGIOCARCINOMA RESECTION SVC002424 50400 65600 75600 85700 95800HOLLOW VISCUS PERFORATION CLOSURE (OPEN) SVC002425 15800 20600 23700 26900 30100HYDATID CYSTOPERICYSTECTOMY (OPEN) SVC002508 32400 42200 48600 55100 61600ILEAL RESECTION INCLUDING TUMOR SEGMENT AND DOUBLE BARREL ILEOSTOMY SVC011689 24200 31500 36300 41200 46000ILEOSTOMY / COLOSTOMY CLOSURE SVC002427 20800 27100 31200 35400 39600ILEOSTOMY / COLOSTOMY DIVERSION SVC002544 25000 32500 37500 42500 47500INCISION & DRAINAGE - MAJOR SVC002593 7000 7000 9100 10500 11900 13300INCISION & DRAINAGE - MINOR SVC002594 5200 5200 6800 7800 8900 9900INCISIONAL HERNIA REPAIR (OPEN) SVC002484 17900 23300 26900 30500 34100INGUINAL HERNIOPLASTY (BILATERAL) SVC002512 21000 27300 31500 35700 39900INGUINAL HERNIOPLASTY (UNILATERAL) SVC002504 16800 21900 25200 28600 32000INTERNAL HERNIA WITH MALROTATION OF GUT SVC011894 34700 45200 52100 59000 66000INTUSSUSCEPTION SVC002698 17900 23300 26900 30500 34100ISCHIORECTAL ABSCESS SVC002666 10500 13700 15800 17900 20000LAP APPENDICULAR ABSCESS DRAINAGE SVC002671 13700 17900 20600 23300 26100LAP EXCISION OF MULTIPLE BAND SVC013652 23100 30100 34700 39300 43900LAP STRICTUROPLASTY SVC013653 23100 30100 34700 39300 43900LAP VENTRAL HERNIOPLASTY SVC013654 34700 45200 52100 59000 66000LAP/OPEN VENTRAL/ EPIGASTRIC/ UMBLICAL HERNIA- SMALL SVC002658 23600 30700 35400 40200 44900

LAP/OPEN VENTRAL/EPIGASTRIC/UMBLICAL HERNIA IRREDUCIBLE SVC002664 34700 45200 52100 59000 66000LAPAROSCOPIC ANTERIOR RESECTION SVC002430 46700 60800 70100 79400 88800LAPAROSCOPIC APPENDICECTOMY SVC002533 21400 27900 32100 36400 40700

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LAPAROSCOPIC BARIATRIC SURGERY GASTRIC BYPASS_NON GST SVC002639 37800 49200 56700 64300 71900

LAPAROSCOPIC BARIATRIC SURGERY SLEEVE GASTRECTOMY_NON GST SVC002640 45400 59100 68100 77200 86300LAPAROSCOPIC CAPD CATHETER INSERTION SVC002642 26300 34200 39500 44800 50000LAPAROSCOPIC CHOLECYSTECTOMY WITH LAPAROSCOPIC CBD EXPLORATION SVC002433 36800 47900 55200 62600 70000LAPAROSCOPIC CHOLEDOCHAL CYST EXCISION WITH HEPATICOJEJUNOSTOMY SVC002521 42000 54600 63000 71400 79800LAPAROSCOPIC DIAPHRAGMATIC HERNIA REPAIR SVC002514 26300 34200 39500 44800 50000

LAPAROSCOPIC DISTAL PANCREATECTOMY WITH SPLENECTOMY SVC002434 52500 68300 78800 89300 99800LAPAROSCOPIC DUODENAL PERFORATION CLOSURE SVC002435 25200 32800 37800 42900 47900LAPAROSCOPIC EXTENDED HEMICOLECTOMY SVC002524 31500 41000 47300 53600 59900LAPAROSCOPIC GASTROJEJUNOSTOMY + VAGOTOMY SVC002436 36800 47900 55200 62600 70000LAPAROSCOPIC HELLER'S CARDIOMYOTOMY SVC007806 34700 45200 52100 59000 66000LAPAROSCOPIC HYDATID CYST EXCISION SVC002438 36800 47900 55200 62600 70000LAPAROSCOPIC INTESTINAL INTER LOOP ADHESIOLYSIS SVC002675 35300 45900 53000 60100 67100LAPAROSCOPIC LIVER ABSCESS DRAINAGE SVC002440 25200 32800 37800 42900 47900LAPAROSCOPIC NEPHRECTOMY SVC002517 31500 41000 47300 53600 59900LAPAROSCOPIC OVARIAN CYSTECTOMY SVC003117 23100 30100 34700 39300 43900LAPAROSCOPIC OVARIAN DRILLING SVC002442 16700 21800 25100 28400 31800LAPAROSCOPIC PANCREATIC NECROSECTOMY SVC002443 42000 54600 63000 71400 79800LAPAROSCOPIC PARTIAL GASTRECTOMY SVC002444 31500 41000 47300 53600 59900LAPAROSCOPIC PARTIAL SPLENECTOMY SVC012877 12200 15900 18300 20800 23200LAPAROSCOPIC RECTOPEXY SVC002446 25200 32800 37800 42900 47900LAPAROSCOPIC RETROPERITONEAL LYMPH NODE BIOPSY SVC002509 14700 14700 19200 22100 25000 28000LAPAROSCOPIC TOTAL PROCTOCOLECTOMY WITH ILEOSTOMY SVC002495 46200 60100 69300 78600 87800LAPAROSCOPIC URETERIC RE IMPLANTATION((BILATERAL) SVC002649 73500 95600 110300 125000 139700LAPAROSCOPIC VAULT SUSPENSION SVC002564 27900 36300 41900 47500 53100LAPAROSCOPY DIVERSION OF INTESTINAL BAND SVC002810 31500 41000 47300 53600 59900Lapcecopexy SVC011893 31500 41000 47300 53600 59900

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteLAPCHOLECYSTECTOMY WITH APPENDISECTOMY SVC002582 37800 49200 56700 64300 71900LAPROSCOPIC CHOLECYSTECTOMY PKG PKG014718 69900 90900 104900 118900 132900LAPROSCOPIC CHOLEDOCHO DUODENOSTOMY SVC007942 28900 37600 43400 49200 55000LAPROSCOPIC CORRECTION OF MALROTATION OF GUT SVC007964 36800 47900 55200 62600 70000LAPROSCOPIC CYSTOPROSTATECTOMY SVC002809 68300 88800 102500 116200 129800LARGE INCISIONAL/VENTRAL HERNIA REPAIR SVC002583 23600 30700 35400 40200 44900LATERAL ANAL SPHINCTEROTOMY SVC002447 9700 12700 14600 16500 18500LIVER RESECTION ( OPEN) SVC002597 52000 67600 78000 88400 98800LORD'S PROCEDURE SVC002449 3700 4900 5600 6300 7100LUMP (LARGE) SVC002570 11100 14500 16700 18900 21100LUMP (MEDIUM) SVC002569 9200 12000 13800 15700 17500LUMP (SMALL) SVC002568 6100 8000 9200 10400 11600LYMPH NODE BIOPSY PKG PKG003324 12300 12300 16000 18500 21000 23400MANAGEMENT OF PERFORATION PERITONITIS SVC002591 37800 49200 56700 64300 71900MESOCAVAL SHUNT SVC002450 29400 38300 44100 50000 55900MULTIPLE LIPOMA SVC013360 26300 34200 39500 44800 50000NAIL BED EXCISION SVC002604 4100 5400 6200 7000 7800OPEN ADHESIOLYSIS SVC002452 15100 19700 22700 25700 28700OPEN ADRENALECTOMY SVC002405 37600 48900 56400 64000 71500OPEN APPENDICECTOMY SVC002453 14700 19200 22100 25000 28000OPEN CHOLECYSTECTOMY SVC002478 18900 24600 28400 32200 36000OPEN HEMORRHOIDECTOMY SVC002536 11600 15100 17400 19800 22100OPEN SMALL BOWEL RESECTION SVC002465 17400 22700 26100 29600 33100PANCREATIC NECROSECTOMY (OPEN) SVC002455 36800 47900 55200 62600 70000PANCREATICO - DUODENECTOMY (WHIPPLE'S) SVC002555 57800 75200 86700 98300 109900PANCREATICO -JEJUNOSTOMY SVC002487 33600 43700 50400 57200 63900PARAPHIMOSIS REDUCTION SVC002606 4500 5900 6800 7700 8600PARAUMBILICAL HERNIA REPAIR (LAPAROSCOPIC) SVC002549 17900 23300 26900 30500 34100PARTIAL GASTRECTOMY (OPEN) SVC002456 23100 30100 34700 39300 43900PILONIDAL SINUS EXCISION SVC002457 12600 16400 18900 21500 24000PILONIDAL SINUS EXCISION WITH ROTATION FLAP COVER SVC002479 23100 30100 34700 39300 43900PORTOCAVAL ANASTOMOSIS SVC002632 26300 34200 39500 44800 50000

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteRADICAL CHOLECYSTECTOMY SVC002518 55500 72200 83300 94400 105500RADICAL GASTRECTOMY (OPEN) SVC002460 31500 41000 47300 53600 59900REMOVAL OF INFECTED MESH SVC002575 24200 31500 36300 41200 46000REPAIR OF RECTO VAGINAL/RECTO VESICAL FISTULA SVC002511 27300 35500 41000 46500 51900RESECTION ANASTOMOSIS (LARGE INTESTINE) SVC002708 36800 47900 55200 62600 70000RESUTURING (EXTERNAL MINOR WOUNDS) SVC010737 1100 1100 1500 1700 1900 2100RESUTURING (LARGE WOUNDS) SVC010813 5300 5300 6900 8000 9100 10100RETROPERITONEAL MASS EXCISION SVC002554 26300 34200 39500 44800 50000SEGMENTAL COLECTOMY SVC012916 23100 30100 34700 39300 43900SPLENECTOMY & ESOPHAGO GASTIC DEVASCULARISATION SVC011619 68300 88800 102500 116200 129800SPLENECTOMY (LAPAROSCOPIC) SVC002557 26300 34200 39500 44800 50000SPLENECTOMY (OPEN) SVC002467 23100 30100 34700 39300 43900STAGING LAPAROSCOPY SVC002674 36800 47900 55200 62600 70000STAPLED HEMORRHOIDECTOMY SVC002468 20800 27100 31200 35400 39600SUPERFICIAL INCISION AND DRAINAGE SVC002500 2600 3400 3900 4500 5000SUPERFICIAL SUTURING SVC002501 1300 1300 1700 2000 2300 2500SUPERFICIAL WOUND DEBRRIDEMENT SVC002502 3500 3500 4600 5300 6000 6700TOTAL OESOPHAGECTOMY WITH GASTRIC PULLUP SVC002470 52500 68300 78800 89300 99800TOTAL PROCTOCOLECTOMY WITH ILEOANAL POUCH SVC002471 31500 41000 47300 53600 59900TOTAL THYROIDECTOMY WITH NECK DISSECTION SVC002488 40500 52700 60800 68900 77000TRANSANAL EXCISION OF RECTAL TUMOR / POLYP SVC002472 10500 13700 15800 17900 20000TRANSHIATAL OESOPHAGECTOMY (THE) SVC010655 57800 75200 86700 98300 109900TRIPLE BYPASS (CA PANCREAS) SVC002528 39200 51000 58800 66700 74500TUBE CEACOSTOMY SVC002659 7400 9700 11100 12600 14100UMBILECTOMY SVC002660 10500 13700 15800 17900 20000UMBILICAL SINUS EXCISION SVC002672 21000 27300 31500 35700 39900VIDEOASSISTED ANAL FISTULA TREATMENT (VAAFT) SVC002626 26300 34200 39500 44800 50000WOUND DEBRIDEMENT - SMALL SVC002565 4000 4000 5200 6000 6800 7600WOUND DELAYED SUTURING SVC002661 12600 16400 18900 21500 24000WOUND GUN-SHOT DEBRIDEMENT SVC002662 12600 16400 18900 21500 24000FISTULECTOMY (LOW) PKG PKG002993 40500 52700 60800 68900 77000LAPAROSCOPIC INGUINAL HERNIA REPAIR B/L (TEP) PKG PKG008984 83300 108300 125000 141700 158300

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteLAPAROSCOPIC INGUINAL HERNIA REPAIR UNILATERAL PKG003880 63600 82700 95400 108200 120900OPEN RECURRENT INGUINAL HERNIA SVC007949 18100 23600 27200 30800 34400EXCISION OF FIBROADENOMA SVC000332 14100 18400 21200 24000 26800RESUTURING OF WOUND SVC000477 15300 15300 19900 23000 26100 29100LAPAROTOMY SVC006886 19000 24700 28500 32300 36100MINOR DEBRIDEMENT SVC011132 3800 3800 5000 5700 6500 7300

ANTERIOR COLPORRHAPHY SVC003068 11400 14900 17100 19400 21700BARTHOLIN CYST EXCISION SVC003156 15300 19900 23000 26100 29100BARTHOLINS ABSCESS DRAINAGE SVC003041 7600 9900 11400 13000 14500BREECH DELIVERY SVC003063 19700 25700 29600 33500 37500BURCH COLPOSUSPENSION SVC003069 26400 34400 39600 44900 50200CERVICAL POLYPECTOMY - LARGE SVC003071 6600 8600 9900 11300 12600CESAREAN HYSTERECTOMY SVC003073 7800 10200 11700 13300 14900COLPOSCOPY OF CERVIX SVC003064 4900 6400 7400 8400 9400COLPOSCOPY OF VULVA SVC003075 4200 5500 6300 7200 8000CONE BIOPSY SVC003076 5700 5700 7500 8600 9700 10900CRYOSURGERY SVC003044 4000 5200 6000 6800 7600DELIVERY WITHOUT EPIDURAL SVC003045 11700 15300 17600 19900 22300DIAGNOSTIC HYSTEROSCOPY SVC012884 16300 21200 24500 27800 31000DILATATION AND CURETTAGE SVC003047 15100 19700 22700 25700 28700DILATATION AND CURETTAGE DIAGNOSTIC PKG PKG006527 11600 15100 17400 19800 22100DILATION & CURETTAGE PKG PKG006487 13300 17300 20000 22700 25300ENDOMETRIAL BIOPSY SVC003116 5600 5600 7300 8400 9600 10700EXCISION OF VULVAL MASS LESION SVC003129 15400 20100 23100 26200 29300FRACTIONAL CURETTAGE SVC003049 7600 9900 11400 13000 14500HYDRO TUBATION SVC012891 2400 3200 3600 4100 4600HYSTERECTOMY SVC003081 8600 11200 12900 14700 16400HYSTEROSCOPIC ENDOMETRIAL ABLATION SVC003083 14500 18900 21800 24700 27600HYSTEROSCOPIC MYOMECTOMY SVC003084 13800 18000 20700 23500 26300HYSTEROSCOPIC SEPTAL RESECTION SVC003085 26400 34400 39600 44900 50200HYSTEROSCOPY DIAGNOSTIC SVC003086 11600 15100 17400 19800 22100

Gynecology

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteHYSTEROSCOPY POLYPECTOMY SVC003087 26500 34500 39800 45100 50400HYSTEROTOMY SVC003050 23600 30700 35400 40200 44900INSERTION OF INTRAUTERINE CONTRACEPTIVE DEVICE SVC003051 3300 4300 5000 5700 6300INTERNAL ILIAC ARTERY LIGATION - BILATERAL SVC003148 23100 30100 34700 39300 43900INTERNAL ILIAC ARTERY LIGATION - UNILATERAL SVC003147 18500 24100 27800 31500 35200INTERVAL TUBECTOMY SVC003106 11000 14300 16500 18700 20900INTRA UTERINE INSEMINATION SVC003052 3700 4900 5600 6300 7100LAMAZE SESSION 1 SVC003146 2310 3010 3470 3930 4390LAPAROSCOPIC APPENDICECTOMY PKG PKG006340 69900 90900 104900 118900 132900LAPAROSCOPIC ASSISTED VAGINAL HYSTERECTOMY PKG PKG003974 121300 157700 182000 206300 230500LAPAROSCOPIC CHOLECYSTECTOMY (SIMPLE)-GRADE B PKG PKG003875 105900 137700 158900 180100 201300LAPAROSCOPIC GONADECTOMY / SALPINGO OOPHORECTOMY SVC003090 36200 47100 54300 61600 68800LAPAROSCOPIC MYOMECTOMY SVC003091 21900 28500 32900 37300 41700LAPAROSCOPIC SURGERY FOR ECTOPIC PREGNANCY (SALPINGECTOMY/ SALPINGOTOMY) SVC003094 22700 29600 34100 38600 43200

LAPAROTOMY FOR PPH FOLLOWED BY INTERNAL ILLIAC LIGATION SVC012897 7800 10200 11700 13300 14900LARGE LOOP EXCISION OF TRANSFORMATION ZONE OF CERVIX (LLETZ/LEEP) SVC003118 14500 18900 21800 24700 27600Merina Insertion Level I Pkg PKG014806 6100 8000 9200 10400 11600NON DESCENT VAGINAL HYSTERECTOMY SVC003135 47100 61300 70700 80100 89500NST (NON STRESS TEST) SVC003062 940 1230 1410 1600 1700 1790OMENTECTOMY SVC003119 25500 33200 38300 43400 48500PYOMETRA DRAINAGE SVC003097 6300 8200 9500 10800 12000RADICAL VULVECTOMY SVC003162 40100 52200 60200 68200 76200RECTO VAGINAL FISTULA REPAIR SVC003098 15400 20100 23100 26200 29300RECTOCELE SVC013368 17900 23300 26900 30500 34100REMOVAL OF INTRAUTERINE CONTRACEPTIVE DEVICE SVC003058 2500 3300 3800 4300 4800SALPINGO OOPHRECTOMY ( OPEN) SVC003126 25600 33300 38400 43600 48700SECOND LOOK LAPAROTOMY CYTOREDUCTIVE STUDY SVC003133 42400 55200 63600 72100 80600SLING OPERATION (KHANNAS / PURANDARES / SHIRODKARS) SVC003102 22900 29800 34400 39000 43600SPONTANEOUS ABORTION (SECOND TRIMESTER) SVC003125 13900 18100 20900 23700 26500

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STAGING LAPAROSCOPY WITH MULTIPLE BIOPSY WITH OOPHRECTOMY SVC003159 48600 48600 63200 72900 82700 92400STAGING LAPAROTOMY SVC003163 20100 26200 30200 34200 38200STAGING LAPAROTOMY- TAH WITH BSO WITH RPLND WITH OMENTECTOMY SVC003059 32300 42000 48500 55000 61400TOTAL ABDOMINAL HYSTERECTOMY SVC003060 52000 67600 78000 88400 98800TOTAL LAPAROSCOPY HYSTERECTOMY + BILATRAL SALPINGO OPHERECTOMY + PELVIC LYMPHADENECTOMY SVC012671 84200 109500 126300 143200 160000TRANS OBTURATOR TAPE(TOT ) SVC012921 3700 4900 5600 6300 7100VAGINAL HYSTERECTOMY WITH PELVIC FLOOR REPAIR SVC003109 58700 76400 88100 99800 111600VAGINOPLASTY SVC003110 36100 47000 54200 61400 68600VESICOVAGINAL FISTULA REPAIR SVC003112 37700 49100 56600 64100 71700WERTHEIM'S HYSTERECTOMY SVC003061 76100 99000 114200 129400 144600

BALLOON TEST OCCLUSION SVC003427 19700 25700 29600 33500 37500BALLOON TEST OCCLUSION-COMPLEX SVC003437 40500 52700 60800 68900 77000BILIARY STENTING - 1 STENT SVC003357 17400 22700 26100 29600 33100CAROTID AND OTHER EXTRACRANIAL STENTING SVC003428 62400 81200 93600 106100 118600CAROTID TO CAROTID BYPASS SVC011225 52500 68300 78800 89300 99800Cerebral Revascularisation - Level A SVC013227 85100 110700 127700 144700 161700Cerebral Revascularisation - Level B SVC013228 110300 143400 165500 187600 209600CEREBRAL THROMBOLYSIS (LESS THAN 1 HOUR) SVC003433 37600 48900 56400 64000 71500CEREBRAL THROMBOLYSIS (MORE THAN 1 HOUR) SVC003432 20800 27100 31200 35400 39600CEREBRAL VENOUS STENTING SVC013300 42000 54600 63000 71400 79800CHECK CEREBRAL ANGIOGRAM SVC003429 7000 9100 10500 11900 13300COILING MAJOR SVC003425 46200 60100 69300 78600 87800COILING MINOR SVC003446 37000 48100 55500 62900 70300COILING OF INTRACRANIAL ANEURYSM ATTEMPTED SVC003441 26300 34200 39500 44800 50000COILING SUPRAMAJOR SVC003426 57800 75200 86700 98300 109900CRANIOTOMY SUPRAMAJOR SVC006570 68300 88800 102500 116200 129800ECA, SPINAL EMBOLISATION MAJOR SVC003422 57800 75200 86700 98300 109900ECA, SPINAL EMBOLISATION MINOR SVC003421 34700 45200 52100 59000 66000

Interventional Neurology

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteEXTRA CRANEAL VENOUS THROMBOLYSIS SVC003444 17400 22700 26100 29600 33100INTRACRANEAL VENOUS THROMBOLYSIS SVC003443 57800 75200 86700 98300 109900INTRACRANIAL ANGIOPLASTY SVC003418 46200 60100 69300 78600 87800INTRACRANIAL ANGIOPLASTY-COMPLEX SVC003442 63600 82700 95400 108200 120900INTRACRANIAL AVM, DAVF EMBOLISATION SUPRAMAJOR SVC003424 52500 68300 78800 89300 99800INTRACRANIAL AVM,DAVF EMBOLISATION MAJOR SVC003423 41600 54100 62400 70800 79100

INTRACRANIAL ENDOVASCULAR MECHANICAL THROMBECTOMY SVC003435 41600 54100 62400 70800 79100INTRACRANIAL STENTING MAJOR SVC003419 58500 76100 87800 99500 111200INTRARTERIAL VASODILATATION SVC003436 16200 21100 24300 27600 30800NEEDLE EMG SVC003431 2400 3200 3600 4100 4600PERIPHERAL ARTERY EMBOLIZATION SVC003439 22000 28600 33000 37400 41800PERIPHERAL ARTERY EMBOLIZATION-COMPLEX SVC003440 34700 45200 52100 59000 66000PERIPHERAL MECHANICAL THROMBOLYSIS SVC003434 51600 67100 77400 87800 98100SPINAL ANGIOGRAM MAJOR SVC003417 20800 27100 31200 35400 39600SPINAL ANGIOGRAM MINOR SVC003416 15100 19700 22700 25700 28700VARICOSE VEINS EVT _PKG PKG006662 75600 98300 113400 128600 143700VENOUS THROMBECTOMY SVC011112 31500 41000 47300 53600 59900VENOUS THROMBECTOMY ATTEMPTED SVC013495 15800 20600 23700 26900 30100COMPLEX EMBOLISATION_PKG PKG006678 147700 192100 221600 251100 280700EMBOLIZATION - COMPLEX SVC003342 40500 52700 60800 68900 77000EMBOLIZATION - MODERATE SVC003346 32400 42200 48600 55100 61600EMBOLIZATION - SIMPLE SVC003338 28300 36800 42500 48200 53800

ENDOVASCULAR ANEURYSM REPAIR WITH FENESTRATED STENT GRAFT SVC003344 92400 120200 138600 157100 175600PERIPHERAL THROMBOLYSIS SVC003411 23100 30100 34700 39300 43900CAROTID BODY TUMOUR SVC011137 57400 74700 86100 97600 109100CAROTID STENTING (EM) PKG PKG004782 121300 157700 182000 206300 230500THROMBOLYSIS (ARTERIAL OR VENOUS) SVC011091 40500 52700 60800 68900 77000

BRONCHIAL ARTERY EMBOLISATION (BAE) SVC003383 17400 17400 22700 26100 29600 33100Interventional Radiology

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteBRONCHIAL ARTERY EMBOLISATION (BAE) (HEMOPTYSIS) WITH GELFOAM PKG PKG004098 117400 152700 176100 199600 223100CATH DIRECTED VENUS THROMBOLYSIS WITH FILTER PKG PKG003138 83900 109100 125900 142700 159500CATHETER DIRECTED PERIPHERAL ARTERIAL THROMBOLYSIS (TWO SESSIONS) PKG PKG004099 72100 93800 108200 122600 137000COLONIC STENT_PKG PKG006668 50400 65600 75600 85700 95800

CORROBORATIVE CT LIMITED POST-PROCEDURE WITHOUT FILMS SVC003410 2100 2100 2800 3200 3600 4000CT FNAC_PKG PKG014903 8100 10600 12200 13800 15400CT NERVE ROOT_PKG PKG014902 13400 17500 20100 22800 25500FENESTRATED STENT GRAFT_PKG PKG006679 302000 392600 453000 513400 573800FIBROID EMBOLISATION PACKAGE PKG008754 117400 152700 176100 199600 223100FISTULA LYSIS PLUS FISTULOPLASTY_PKG PKG006680 109100 141900 163700 185500 207300FISTULA LYSIS_PKG PKG006689 42100 54800 63200 71600 80000FISTULOPLASTY COMPLEX_PKG PKG006690 114500 148900 171800 194700 217600FISTULOPLASTY CUTTING BALLOON_PKG PKG008763 79300 103100 119000 134900 150700FISTULOPLASTY_PKG PKG014900 58800 76500 88200 100000 111800FOAM SCLEROTHERAPY (PER INJECTION)_PKG PKG004113 11600 15100 17400 19800 22100FOAM SCLEROTHERAPY_PKG PKG004112 47100 61300 70700 80100 89500GASTRIC STENT_PKG PKG006691 45800 59600 68700 77900 87100HICKMAN LINE_PKG PKG007963 36700 47800 55100 62400 69800HYDATID CYST_PKG PKG007367 30500 39700 45800 51900 58000ILIAC OCCLUSION_PKG PKG006669 109100 141900 163700 185500 207300IMAGE GUIDANCE IN OT SVC003414 9800 9800 12800 14700 16700 18700IMAGE GUIDANCE IN OT(SHORT) SVC003413 3500 3500 4600 5300 6000 6700IMAGE GUIDED CELIAC/SPLANCHNIC/SUPERIOR HYPOGASTRIC PLEXUS BLOCK / NEUROLYSIS SVC003375 9300 9300 12100 14000 15900 17700IMAGE GUIDED JOINT / TENDON SHEATH INJECTION SVC003374 3500 3500 4600 5300 6000 6700IMAGE GUIDED NERVE BLOCK-ONE SITE SVC003406 3200 3200 4200 4800 5500 6100IMAGE GUIDED TUNELLED CATHETER / CHEMOPORT INSERTION SVC003372 13900 13900 18100 20900 23700 26500INTERCOSTAL NEUROLYSIS_PKG PKG006906 16800 21900 25200 28600 32000INTERNALISATION OF EXTERNAL PTBD SVC003377 11600 11600 15100 17400 19800 22100

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteINTRAVASCULAR FOREIGN BODY RETRIEVAL SVC003324 23100 23100 30100 34700 39300 43900INTRAVASCULAR FOREIGN BODY RETRIEVAL PKG PKG004104 36700 47800 55100 62400 69800IR REVIEW SVC003401 840 1100 1260 1430 1520 1600JUVENILE ANGIOFIBROMA_PKG PKG008953 100700 131000 151100 171200 191400MICROWAVE ABLATION_PKG PKG006670 134300 174600 201500 228400 255200MODERATE EMBOLISATION_PKG PKG004107 114200 148500 171300 194200 217000NEPHROSTOMY BOTH SIDES_PKG PKG004775 43700 56900 65600 74300 83100NEPHROSTOMY ONE SIDE_PKG PKG007878 24400 31800 36600 41500 46400NERVE BLOCK_PKG PKG007667 13400 17500 20100 22800 25500NUCLEOPLASTY SVC010630 30800 30800 40100 46200 52400 58600OBSTETRIC HEMORRHAGE_PKG PKG006646 75600 98300 113400 128600 143700OESOPHAGEAL STENT_PKG PKG006671 40200 52300 60300 68400 76400PARTIAL SPLENIC EMBOLISATION_PKG PKG006684 134300 174600 201500 228400 255200PELVIC CONGESTION SYNDROME_PKG PKG009385 107300 139500 161000 182500 203900PERC CHOLECYSTOSTOMY_PKG PKG014898 30300 39400 45500 51600 57600PERCUTANEOUS ASPIRATION AND REINSTILLATION (PAIR) FOR HYDATID CYST SVC003379 10500 13650 15750 17850 18900 19950

PERCUTANEOUS BILIARY DRAINAGE (PTBD) EXTERNAL DRAINAGE SVC003312 13900 13900 18100 20900 23700 26500PERCUTANEOUS BILIARY DRAINAGE (PTBD) INTERNAL DRAINAGE + PLASTIC STENTING PKG PKG004101 152500 198300 228800 259300 289800PERCUTANEOUS IMAGE GUIDED SCLEROTHERAPY (VENOUS MALFORMATION / HEMANGIOMA) SVC003318 8100 8100 10600 12200 13800 15400

PERCUTANEOUS NEPHROSTOMY (PCN) (OBSTRUCTIVE UROPATHY) SVC003323 13000 13000 16900 19500 22100 24700PERCUTANEOUS PSEUDOANEURYSM_PKG PKG009416 15200 19800 22800 25900 28900PERCUTANEOUS TRANS HEPATIC BILIARY DRAINGE (PTBD)-EXTERNAL+INTERNAL SVC003407 15800 15800 20600 23700 26900 30100PLUGGED RENAL BIOPSY_PKG PKG006686 15200 15200 19800 22800 25900 28900PORT INSERTION COMPLEX_PKG PKG007946 87300 113500 131000 148500 165900PORT INSERTION_PKG PKG007944 63800 83000 95700 108500 121300PROSTATIC ARTERY EMBOLISATION SVC003347 34700 34700 45200 52100 59000 66000

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuitePROSTATIC ARTERY EMBOLISATION COMPLETE PACKAGE_PKG PKG006645 199600 259500 299400 339400 379300PROSTATIC ARTERY EMBOLISATION COMPLEX_PKG PKG006682 158600 206200 237900 269700 301400PROSTATIC ARTERY EMBOLISATION_PKG PKG006681 92300 120000 138500 157000 175400RADIOEMBOLISATION_PKG PKG006683 377500 490800 566300 641800 717300REMOVAL OF IVC FILTER SVC003389 23100 30030 34650 39270 41580 43890RENAL BIOPSY - PLUGGED SVC003353 7000 7000 9100 10500 11900 13300RENAL PLASTY_PKG PKG006672 104000 135200 156000 176800 197600RIG_PKG PKG014899 63800 83000 95700 108500 121300SFA OCCLUSION_PKG PKG006673 97100 126300 145700 165100 184500SIMPLE EMBOLISATION_PKG PKG006675 52900 68800 79400 90000 100600SVC OCCLUSION, SNARE_PKG PKG014894 92300 120000 138500 157000 175400TENDON INJECTION_PKG PKG006687 10200 13300 15300 17400 19400TIPSS ALL INCLUSIVE_PKG PKG014895 503200 654200 754800 855500 956100TIPSS GRAM_PKG PKG006655 18300 23800 27500 31200 34800TRACHEAL STENT_PKG PKG010004 39700 51700 59600 67500 75500TRANS-ARTERIAL CHEMO-EMBOLIZATION (TACE) (LIVER TUMORS / METASTASES ) PKG PKG006658 100700 131000 151100 171200 191400TRANSJUGULAR PORTO-SYSTEMIC SHUNT( TIPSS) PKG PKG006654 343100 446100 514700 583300 651900TRUS BIOPSY_PKG PKG010014 16100 16100 21000 24200 27400 30600TRUS GUIDED PROSTATE BIOPSY SVC003390 9240 12020 13860 15710 16640 17560TUMOUR ABLATION - SINGLE - A_PKG PKG004105 106800 138900 160200 181600 203000TUMOUR ABLATION: MULTIPLE (A)_PKG PKG006676 167800 218200 251700 285300 318900URETERIC STENT ONE_PKG PKG008905 45800 59600 68700 77900 87100URETERIC STENT PRIOR NEPHROSTOMY_PKG PKG006688 30300 39400 45500 51600 57600URETERIC STENT TWO_PKG PKG008904 67200 87400 100800 114300 127700USG GUIDED BIOPSY-SUPERFICIAL SVC003412 6800 6800 8900 10200 11600 13000USG GUIDED COMPRESSION THROMBOSIS OF PSEUDOANEURYSM OR THROMBIN INJECTION SVC003382 11550 15020 17330 19640 20790 21950USG GUIDED FLUID TAPPING ASCITIC DIAGNOSTIC SVC003394 3780 4920 5670 6430 6810 7190USG GUIDED FLUID TAPPING ASCITIC THERAPEUTIC SVC003395 6960 9050 10440 11840 12530 13230USG GUIDED FLUID TAPPING PLEURAL DIAGNOSTIC SVC003396 3470 4520 5210 5900 6250 6600USG GUIDED FLUID TAPPING PLEURAL THERAPEUTIC SVC003397 6300 6300 8200 9500 10800 12000

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteUSG GUIDED FNAC (SUPERFICIAL) SVC003408 4400 4400 5800 6600 7500 8400USG GUIDED PER CUTANEOUS COLLECTION OF DRAINAGE SVC003392 5780 7520 8670 9830 10410 10990UTERINE ARTERY EMBOLISATION (MENORRHAGIA / FIBROID / ADENOMYOSIS) SVC003310 34700 34700 45200 52100 59000 66000UTERINE ARTERY EMBOLISATION (MENORRHAGIA / FIBROID / ADENOMYOSIS) PKG PKG006644 112200 145900 168300 190800 213200VARICOCELE EMBOLISATION SVC003355 23100 23100 30100 34700 39300 43900VARICOCELE EMBOLISATION BOTH_PKG PKG010143 140800 183100 211200 239400 267600VARICOCELE EMBOLISATION_PKG PKG010144 107300 139500 161000 182500 203900VARICOSE VEIN LASER 2 LIMBS_PKG PKG008666 218100 283600 327200 370800 414400VARICOSE VEIN LASER ABLATION (EVLT) (FOR SINGLE LIMB) SVC003322 28900 28900 37600 43400 49200 55000

VARICOSE VEIN LASER ABLATION (EVLT) (FOR SINGLE LIMB) PKG PKG003004 28900 37600 43400 49200 55000VARICOSE VEIN LASER GSV 1 LIMB_PKG PKG007930 87300 113500 131000 148500 165900VARICOSE VEINS - LASER - MULTIPLE VEINS - UNILATERAL SVC003362 116000 116000 150800 174000 197200 220400VARICOSE VEINS COMPLEX PER LIMB_PKG PKG006661 184500 239900 276800 313700 350600VARICOSE VEINS LASER 2 LIMBS PLUS FOAM_PKG PKG010145 251600 327100 377400 427800 478100VARICOSE VEINS LASER PLUS FOAM 1 LIMB_PKG PKG004111 144300 187600 216500 245400 274200VERTEBROPLASTY_PKG PKG007670 91500 119000 137300 155600 173900

(1, 3)-BETA-D-GLUCAN (BDG) SVC013488 10500 13650 15750 17850 18900 19950100GM GTT ( GESTATIONAL) FASTING,1HR,2HR,3HR SVC005271 410 540 620 700 740 780PROTEIN S ANTIGEN, FREE SVC013633 5000 5000 5000 5000 5000 5000ANTITHROMBIN ACTIVITY, FUNCTIONAL SVC005527 2850 2850 2850 2850 2850 2850ONCOPRO HEREDITARY CANCER RISK PANEL SVC013670 28000 28000 28000 28000 28000 28000Lung Cancer 12 Gene Panel with PDL1 - Ventana SP263 SVC013795 30000 30000 30000 30000 30000 30000PLASMA FOR CATECHOLAMINES SVC004677 7200 7200 7200 7200 7200 7200ONCOPRO NCCN LUNG CANCER PANEL SVC014000 100000 100000 100000 100000 100000 100000ROS 1 by FISH SVC013312 6500 6500 6500 6500 6500 6500NEISSERIA GONORRHEA QUALITATIVE PCR SVC013941 3500 3500 3500 3500 3500 350024 HOURS URINE CREATININE CLEARANCE TEST SVC003460 620 810 930 1060 1120 118024 HOURS URINE FOR CALCIUM SVC003461 300 390 450 510 540 570

Laboratory

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe Suite24 HOURS URINE FOR CALCIUM-CREATININE RATIO SVC004472 480 630 720 820 870 92024 HOURS URINE FOR CREATININE SVC003900 300 390 450 510 540 57024 HOURS URINE FOR ELECTROLYTES SVC003455 500 650 750 850 900 95024 HOURS URINE FOR MAGNESIUM SVC003901 670 880 1010 1140 1210 128024 HOURS URINE FOR PHOSPHORUS SVC003462 330 430 500 570 600 63024 HOURS URINE FOR POTASSIUM SVC003458 270 360 410 460 490 52024 HOURS URINE FOR PROTEIN SVC003459 330 430 500 570 600 63024 HOURS URINE FOR UREA SVC005015 340 450 510 580 620 65024 HOURS URINE FOR URIC ACID SVC003463 330 430 500 570 600 63024 HOURS URINE PROTEIN/CREATININE RATIO SVC004746 590 770 890 1010 1070 11305 FLUOROURACIL (5FU) TOXICITY SVC013640 7350 9560 11030 12500 13230 1397050 GM OGCT ( GESTATIONAL) 1 HR SVC005274 170 230 260 290 310 33056 GENE TEST SVC012787 44100 57330 66150 74970 79380 8379056 GENE TEST - LIQUID BIOPSY SVC012788 44100 57330 66150 74970 79380 8379056 GENE TEST BY NGS 56 GENES SVC006162 44100 57330 66150 74970 79380 8379075 GM - EXTENDED GTT -FASTING,1HR,2HR,3HR,4HR SVC005273 510 670 770 870 920 97075 GM GTT - FASTING,1HR,2HR,3HR SVC005272 460 600 690 790 830 88075 GM GTT - FASTING,2HR SVC005275 170 230 260 290 310 33075 GM GTT ( GESTATIONAL) FASTING,1HR,2HR SVC005270 280 370 420 480 510 540Â HEPARIN INDUCED THROMBOCYTOPENIA (HIT); ANTI PLATELET FACTOR 4-HEPARIN (PF4-H), IgG QUANTITATIVE SVC013518 12500 16250 18750 21250 22500 23750ABL1 KINASE DOMAIN MUTATION SVC012753 8400 10920 12600 14280 15120 15960ABSOLUTE LEUKOCYTE COUNT SVC005948 160 210 240 280 290 310ABSOLUTE LYMPHOCYTE TEST SVC003903 180 240 270 310 330 350ABSOLUTE NEUTROPHIL TEST SVC003904 180 240 270 310 330 350ACT (ACTIVATED CLOTTING TIME) SVC003907 180 240 270 310 330 350ACUTE ENCEPHALITIC SYNDROME SVC004977 19850 25810 29780 33750 35730 37720ADENO VIRUS IGM SVC003909 1440 1880 2160 2450 2600 2740ADENOVIRUS QUANTIFICATION SVC005402 4310 5610 6470 7330 7760 8190ADP TEST SVC005152 1550 2020 2330 2640 2790 2950AEC (ABSOLUTE ESONIPHIL COUNT) SVC003468 200 260 300 340 360 380AFB CULTURE & RADIOMETRIC SUSCEPTIBILITY - SIREP PANEL SVC003913 5630 7320 8450 9580 10140 10700

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteAFB IDENTIFICATION BY NAP SVC003914 1330 1730 2000 2270 2400 2530AFB SMEAR SVC003472 230 300 350 400 420 440AIR CULTURE SVC004778 900 1170 1350 1530 1620 1710AIR SAMPLING (PER ROOM/OT) SVC003916 1110 1450 1670 1890 2000 2110ALBUMIN TO GLOBULIN (A/G)RATIO SVC003880 380 500 570 650 690 730ALK MUTATION SVC004787 11150 14500 16730 18960 20070 21190ALKALINE PHOSPHATASE (ALP) SVC003474 210 280 320 360 380 400ALLERGY EUROLINE (FOOD ALLERY PANEL) SVC004897 3970 5170 5960 6750 7150 7550ALLERGY MARKER FOR ANIMAL PANEL SVC004428 4410 5740 6620 7500 7940 8380ALLERGY MARKER FOR DUST PANEL SVC004430 3870 5040 5810 6580 6970 7360ALLERGY MARKER FOR FOOD PANEL SVC004432 7180 9340 10770 12210 12930 13650ALLERGY MARKER FOR MOLD PANEL SVC004435 4410 5740 6620 7500 7940 8380ALLERGY MARKER FOR TREE PANEL SVC004439 4970 6470 7460 8450 8950 9450ALLERGY MARKER-GLUTEN SVC004372 1990 2590 2990 3390 3590 3790ALLERGY- NON VEGETARIAN PANEL SVC004436 4970 6470 7460 8450 8950 9450ALLERGY POST SCREEN PROFILE SVC004446 12690 16500 19040 21580 22850 24120ALLERGY- PULSES PANEL SVC004438 3310 4310 4970 5630 5960 6290ALLERGY SCREEN SVC004445 1770 2310 2660 3010 3190 3370ALPHA GLUCOSIDASE ENZYME ASSAY FOR POMPE DISEASE SVC004553 5080 6610 7620 8640 9150 9660AMINO ACIDS, ORGANIC ACIDS, FATTY ACIDS DISORDERS (TANDEM MASS SPECTROMETRY) SVC003922 3310 4310 4970 5630 5960 6290AML COMBO QUEST V (COMBO PANEL OF NPM 1 EXON12&FLT3(ITD&D835) AND CEBPA MUTATION ANALYSIS. ) SVC004982 14130 18370 21200 24030 25440 26850ANA IMMUNOFLUOROSCENCE SVC004903 3050 3970 4580 5190 5490 5800ANAESTHESIA TROLLEY SWAB SVC004847 470 620 710 800 850 900ANTEGRADE PYELOGRAPHY SVC013142 10500 10500 13700 15800 17900 20000ANTI - HBS TITRE SVC003929 1000 1300 1500 1700 1800 1900ANTI - L/P (LIVER/PANCREAS) SVC003930 2260 2940 3390 3850 4070 4300ANTI A TITER SVC003931 1300 1300 1300 1300 1300 1300ANTI A TITRE IGG SVC006090 1050 1370 1580 1790 1890 2000ANTI B TITER SVC003932 1300 1300 1300 1300 1300 1300ANTI D TITRE SVC005138 320 420 480 550 580 610

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteANTI HAV-TOTAL SVC003482 1720 2240 2580 2930 3100 3270ANTI HCV IGG SVC003485 2330 3030 3500 3970 4200 4430ANTI HCV IGM SVC003486 2550 3320 3830 4340 4590 4850ANTI INTRINSIC FACTOR IGG SVC003935 2260 2940 3390 3850 4070 4300ANTI JO-1 ANTIBODY SVC004581 1500 1950 2250 2550 2700 2850ANTI NUCLEAR ANTIBODY / FACTOR (ANA/ANF), IFA (HEP-2) SVC003493 2430 3160 3650 4140 4380 4620ANTI NUCLEAR ANTIBODY PROFILE (ANA PROFILE) SVC003937 5780 7520 8670 9830 10410 10990ARTERIAL LINE TIP FOR CULTURE & SENSITIVITY SVC003498 830 1080 1250 1420 1500 1580ASCITIC FLUID FOR CELL COUNT SVC004931 520 680 780 890 940 990ASCITIC FLUID FOR CYTOLOGY/MALIGNANT CELLS SVC003499 510 670 770 870 920 970ASCITIC FLUID FOR GLUCOSE SVC005050 100 130 150 170 180 190

ASCITIC FLUID ROUTINE ANALYSIS (CELL COUNT AND BIOCHEMISTRY) SVC011269 870 1140 1310 1480 1570 1660ASLO QUALITATIVE SVC003500 360 470 540 620 650 690ASO (ANTISTREPTOLYSIN "O") SVC003502 720 940 1080 1230 1300 1370ASPIRATATED FLUID (CLINICAL PATHOLOGY) SVC003954 150 200 230 260 270 290ASPIRATED FLUID ANALYSIS SVC003503 960 1250 1440 1640 1730 1830ASPIRATED FLUID ANALYSIS (BIOCHEMISTRY) SVC003504 510 670 770 870 920 970ASPIRATED FLUID FOR C/S SVC003505 830 1080 1250 1420 1500 1580ASPIRATED FLUID FOR CELL COUNT SVC004940 540 710 810 920 980 1030ASPIRATED FLUID FOR CYTOLOGY SVC004941 530 690 800 910 960 1010ASPIRIN SENSITIVITY SVC004871 1440 1880 2160 2450 2600 2740ASTHMA /RHINITIS SCREENING PANEL SVC005075 7810 10160 11720 13280 14060 14840AUTOIMMUNE HEPATITIS PANEL (AMA, ANTI LKM, ANTI L/P) SVC003487 7400 9620 11100 12580 13320 14060AXILLARY SWAB FOR C/S SVC003955 1110 1450 1670 1890 2000 2110BABY SHIELD 5 CONDITIONS- (HEEL PRICK) SVC005268 1280 1670 1920 2180 2310 2440BACTERIAL MENINGITIS SCREEN SVC005478 2990 3890 4490 5090 5390 5690BAL FLUID - CELL TYPE AND CELL COUNT SVC005234 490 640 740 840 890 940BAL FLUID (BRONCHO ALVEOLAR LAVAGE) FOR AFB STAIN SVC003507 230 300 350 400 420 440BAL FLUID (BRONCHO ALVEOLAR LAVAGE) FOR C/S SVC003508 960 1250 1440 1640 1730 1830BAL FLUID (BRONCHO ALVEOLAR LAVAGE) FOR FUNGAL C/S SVC003509 1230 1600 1850 2100 2220 2340BAL FLUID (BRONCHO ALVEOLAR LAVAGE) FOR GRAMS STAIN SVC003510 210 280 320 360 380 400

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BAL FLUID FOR CYTOLOGY (BRONCHIAL WASH/ALVEOLAR LAVAGE) SVC003511 620 810 930 1060 1120 1180BAL FLUID FOR FUNGAL STAIN SVC003512 210 280 320 360 380 400BBR FREEZE SWAB FOR C/S SVC005026 590 770 890 1010 1070 1130BCR-ABL1 QUALITATIVE ANALYSIS SVC012754 4730 6150 7100 8050 8520 8990BCR-ABL1 RT-QPCR FOR P210 & P190 , ABL1 KINASE DOMAIN MUTATION (SEQUENCING) SVC005821 17850 23210 26780 30350 32130 33920BCR-ABL1 TRANSCRIPT COPIES, RT-QPCR FOR P210 AND P190 SVC005819 10500 13650 15750 17850 18900 19950BED RAILING SWAB SVC004816 470 620 710 800 850 900BILE FOR CULTURE & SENSITIVITY SVC003516 880 1150 1320 1500 1590 1680BILIRUBIN DIRECT SVC003517 160 210 240 280 290 310BILIRUBIN INDIRECT SVC003518 140 190 210 240 260 270BILIRUBIN TOTAL SVC003519 160 210 240 280 290 310BLEEDING TIME (BT) SVC003961 250 330 380 430 450 480BLOCKS CHARGES SVC005247 300 390 450 510 540 570BLOOD CLOT FOR C/S SVC003521 590 770 890 1010 1070 1130BLOOD CROSS MATCHING SVC003963 480 630 720 820 870 920BLOOD CULTURE FOR FUNGUS SVC003522 1220 1590 1830 2080 2200 2320BLOOD FOR C/S SVC003524 1400 1820 2100 2380 2520 2660BLOOD FOR CULTURE & SENSITIVITY AEROBIC SVC003525 1370 1790 2060 2330 2470 2610BLOOD FOR CULTURE AUTOMATED SVC005052 1330 1730 2000 2270 2400 2530BLOOD FOR TBPCR SVC004588 2650 3450 3980 4510 4770 5040BLOOD GROUP & RH TYPING SVC003964 210 280 320 360 380 400BLOOD TRANSFUSION CHARGES (DAY CARE) SVC003965 440 580 660 750 800 840BLOOD UREA NITROGEN (BUN) SVC003529 180 240 270 310 330 350BODY FLUID FOR CYTOLOGY SVC005330 610 800 920 1040 1100 1160BONE MARROW FOR C/S SVC003967 1280 1670 1920 2180 2310 2440BONE PIECE FOR C/S SVC003968 1110 1450 1670 1890 2000 2110BRAF V600E SVC011870 6300 8190 9450 10710 11340 11970BRCA 1, BRCA 2 SVC013796 19640 25540 29460 33390 35360 37320BRCA1 BRCA2 AND TP53 DELETION ALONG WITH ACMG RECOMMANDED GENES GERMLINE PANEL TEST BY NGS SVC006161 25990 33790 38990 44190 46790 49390

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteBRONCHIAL ASPIRATION FOR AFB CULTURE SVC004769 2610 3400 3920 4440 4700 4960BRONCHIAL ASPIRATION FOR CULTURE & SENSITIVITY SVC003527 830 1080 1250 1420 1500 1580BRONCHIAL ASPIRATION FOR FUNGAL STAIN SVC004590 270 360 410 460 490 520BRONCHIAL ASPIRATION FOR GRAM STAIN SVC004767 140 190 210 240 260 270BRONCHIAL ASPIRATION FOR Z-N STAIN SVC004768 160 210 240 280 290 310BRONCHIAL FLUID FOR CYTOLOGY SVC004593 740 970 1110 1260 1340 1410BRONCHIAL SECRETION FOR AFB CULTURE SVC004594 1550 2020 2330 2640 2790 2950BRONCHIAL SECRETION FOR FUNGAL STAIN SVC004595 140 190 210 240 260 270BRONCHIAL SECRETION FOR GRAM STAIN SVC004596 140 190 210 240 260 270BRONCHIAL SECRETION FOR Z-N STAIN SVC004597 250 330 380 430 450 480BRONCHIAL-SECRETION FOR FUNGAL CULTURE SVC004598 390 510 590 670 710 750BT/CT BLEEDING TIME & CLOTTING TIME SVC003528 230 300 350 400 420 440C -REACTIVE PROTEIN (CRP) -QUALITATIVE SVC004735 200 260 300 340 360 380CAG/PTCA PROFILE SVC011341 3760 4890 5640 6400 6770 7150CALCIUM SVC003533 270 360 410 460 490 520CANCA SVC003534 1890 2460 2840 3220 3410 3600CAPD FLUID FOR BIOCHEMISTRY SVC004932 490 640 740 840 890 940CAPD FLUID FOR CELL COUNT SVC004933 490 640 740 840 890 940CAPD FLUID FOR CULTURE & SENSITIVITY SVC003535 830 1080 1250 1420 1500 1580CAPD FLUID FOR CYTOLOGY SVC004602 510 670 770 870 920 970CAPD FLUID FOR FUNGAL CULTURE SVC003536 1160 1510 1740 1980 2090 2210CAPD FLUID FOR FUNGAL STAIN SVC004600 130 170 200 230 240 250CAPD FLUID FOR GRAM STAIN SVC004601 130 170 200 230 240 250CARDIAC PANEL - CARDIAC TROPONIN I, CREATINE PHOSPHOKINASE-MB (CPK-MB) SVC004567 820 1070 1230 1400 1480 1560CARDIAC PANEL POC (SOB PANEL) [PROFILE] SVC005393 2700 3510 4050 4590 4860 5130CARDIAC TABLE SWAB SVC004823 470 620 710 800 850 900CATH STUDY/DEVICE CLOSURE/EPS/RFA/BMV2 SVC011340 3870 5040 5810 6580 6970 7360CAVAFIX TIP FOR C/S SVC003539 490 640 740 840 890 940CD 45 SVC004655 2330 3030 3500 3970 4200 4430CD 55 SVC003979 1600 2080 2400 2720 2880 3040CD 59 SVC003980 1600 2080 2400 2720 2880 3040

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteCDC CROSS MATCHING SVC005388 3040 3960 4560 5170 5480 5780CELIAC PROFILE (TTG IGA ANTIBODY ,GLIADIN IGG & IGA) SVC003985 3480 4530 5220 5920 6270 6620CENTRAL LINE TIP FOR C/S SVC003541 830 1080 1250 1420 1500 1580CEREBROSPINAL FLUID (CSF) FOR CYTOLOGY SVC004927 530 690 800 910 960 1010CERVICAL SCREENING PANEL ( PAP SMEAR; HPV DETECTION &GENOTYPING) SVC005173 1600 2080 2400 2720 2880 3040CERVICAL SMEAR FOR CYTOLOGY SVC004606 940 1230 1410 1600 1700 1790CERVICAL SWAB FOR C/S SVC003543 830 1080 1250 1420 1500 1580CHLORIDE SVC003545 170 230 260 290 310 330CHOLESTEROL /HDL RATIO SVC004228 1120 1460 1680 1910 2020 2130CHOLESTEROL TOTAL SVC003546 170 230 260 290 310 330CHROMOSOMAL BREAKAGE STUDY (MYTOMYCIN INDUCED) SVC003995 6620 8610 9930 11260 11920 12580CHROMOSOME ANALYSIS, HEMATOLOGIC MALIGNANCY, BLOOD/BONE MARROW SVC005171 3530 4590 5300 6010 6360 6710CHYLE TEST SVC004607 270 360 410 460 490 520CHYLOMICRON SVC005289 450 590 680 770 810 860CLOTTING TIME (CT) SVC003997 260 340 390 450 470 500CLPD - PANEL SVC003998 10920 14200 16380 18570 19660 20750CMV DNA PCR SVC005291 4310 5610 6470 7330 7760 8190COAGGLUTINATION TEST SVC004001 340 450 510 580 620 650COAGULATION PROFILE SVC005000 2380 3100 3570 4050 4290 4530COBALT-BLOOD SVC005671 3530 4590 5300 6010 6360 6710COLORECTAL CANCER PANEL SVC012806 14340 18650 21510 24380 25820 27250COLORECTAL CANCER PANEL WITH MSI BY IHC: KRAS, NRAS & BRAF SEQUENCING + MSI BY IHC SVC012808 22050 28670 33080 37490 39690 41900COLORECTAL CANCER PANEL WITH MSI BY PCR: KRAS, NRAS & BRAF SEQUENCING + MSI BY PCR SVC012807 25360 32970 38040 43120 45650 48190COMPLETE BLOOD COUNT (CBC) SVC011232 480 630 720 820 870 920COMPLETE BLOOD COUNT WITH ALC SVC011307 390 510 590 670 710 750COMPLETE HAEMOGRAM SVC011370 540 710 810 920 980 1030CONJUNCTIVAL SWAB FOR C/S SVC003552 830 1080 1250 1420 1500 1580CONJUNCTIVAL SWAB FOR FUNGAL CULTURE SVC003553 1160 1510 1740 1980 2090 2210

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteCONJUNCTIVAL SWAB FOR GRAM STAIN SVC004610 130 170 200 230 240 250CONJUNCTIVAL SWAB FOR KOH SVC004611 130 170 200 230 240 250CONSTITUTIONAL KARYOTYPING SVC005802 5250 6830 7880 8930 9450 9980CONVENTIONAL KARYOTYPING SVC005791 5250 6830 7880 8930 9450 9980CONVENTIONAL KARYOTYPING (LYMPHOMA) SVC012738 8400 10920 12600 14280 15120 15960CREATINE KINASE (CK/CPK) SVC003558 580 760 870 990 1050 1110CREATINE KINASE- MB (CK-MB) SVC003548 710 930 1070 1210 1280 1350CREATINE KINASE-MB MASS SVC005077 650 850 980 1110 1170 1240CREATININE CLEARANCE SVC004003 560 730 840 960 1010 1070CRP (C -REACTIVE PROTEIN) SVC003559 530 690 800 910 960 1010CSF AFB STAIN SVC003560 190 250 290 330 350 370CSF ANALYSIS (BIOCHEMISTRY) SVC003561 520 680 780 890 940 990CSF ANALYSIS (CLINICAL PATHOLOGY) SVC004008 470 620 710 800 850 900CSF CELL COUNT SVC003562 420 550 630 720 760 800CSF FOR C/S SVC003563 880 1150 1320 1500 1590 1680CSF FOR CYTOLOGY/MALIGNANT CELLS SVC003564 610 800 920 1040 1100 1160CSF FOR FUNGAL CULTURE SVC003565 1220 1590 1830 2080 2200 2320CSF FOR GRAM STAIN SVC003566 170 230 260 290 310 330CSF FOR INDIA INK SVC003567 340 450 510 580 620 650CSF FOR MENINGOCOCCAL AG SVC004011 2210 2880 3320 3760 3980 4200CSF FOR TB - PCR SVC004013 2520 3280 3780 4290 4540 4790CSF FOR TOTAL PROTEIN SVC005055 180 240 270 310 330 350CSF FOR Z-N STAIN (AFB STAIN) SVC003568 180 240 270 310 330 350CSF GRAM STAIN SVC004014 370 490 560 630 670 710CSF PANEL- BIOFIRE METHOD SVC006010 21000 27300 31500 35700 37800 39900CSF PROTEIN ELECTROPHORESIS SVC003569 5520 7180 8280 9390 9940 10490CSSD - ETO SVC005021 490 640 740 840 890 940CSSD - ETO - CONTROL SVC005023 490 640 740 840 890 940CSSD - STEAM SVC005020 490 640 740 840 890 940CSSD - STEAM - CONTROL SVC005022 490 640 740 840 890 940CULTURE AFB ANTIBIOTIC SENSITIVITY - 5 DRUG PANEL SVC004017 6620 8610 9930 11260 11920 12580CULTURE AND SENSITIVITY FOR BIOLOGICAL INDICATOR SVC004453 920 1200 1380 1570 1660 1750

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteCULTURED AFB ANTIBIOTICS SENSITIVITY 10 DRUGS PANEL SVC004583 11590 15070 17390 19710 20870 22030CVP TIP FOR CULTURE & SENSITIVITY SVC003571 830 1080 1250 1420 1500 1580CYSTIC FLUID (BIOCHEMISTRY) SVC003573 470 620 710 800 850 900CYSTIC FLUID FOR CYTOLOGY SVC003574 490 640 740 840 890 940CYTOGENETICS SVC004022 3650 4750 5480 6210 6570 6940CYTOGENETICS (KARYOTYPING) SVC004470 2990 3890 4490 5090 5390 5690CYTOLOGY SVC003575 540 710 810 920 980 1030CYTOLOGY (PAP SMEAR), GENITAL, FEMALE, CONVENTIONAL SVC005296 610 800 920 1040 1100 1160D-DIMER SVC003577 1260 1640 1890 2150 2270 2400DEEP FREEZE SWAB FOR C/S SVC005027 490 640 740 840 890 940DES-GAMMA CARBOXY PROTHROMBIN (DCP)/PIVKA II, SERUM SVC013639 3680 4790 5520 6260 6630 7000DIALYSIS CATHETER TIP FOR C/S SVC003582 830 1080 1250 1420 1500 1580DIALYSIS PACKAGE - 2 SVC011243 950 1240 1430 1620 1710 1810DIALYSIS PROFILE-1 SVC011345 1940 2530 2910 3300 3500 3690DIALYSIS PROFILE-2 SVC011344 4690 6100 7040 7980 8450 8920DIALYSIS SEROLOGY PROFILE(CHEMILUMINESCENCE / ELFA ) SVC011306 2490 3240 3740 4240 4490 4740DIALYSIS VIROLOGY PROFILE (HIV, HCV AND HBS AG ) - RAPID SVC011233 1630 2120 2450 2780 2940 3100DIALYSIS WATER FOR C/S SVC003585 540 710 810 920 980 1030DIFFERENTIAL COUNT (DC) SVC003576 180 240 270 310 330 350DOOR HANDLE SWAB SVC004831 470 620 710 800 850 900DOUBLE BLOOD BAG (350ML) STERILITY TEST SVC004843 740 970 1110 1260 1340 1410DOUBLE BLOOD BAG (450ML) STERILITY TEST SVC004844 740 970 1110 1260 1340 1410DRAIN FLUID FOR AMYLASE SVC004037 830 1080 1250 1420 1500 1580DRAIN FLUID FOR BILIRUBIN SVC004038 290 380 440 500 530 560DRAIN FLUID FOR C/S SVC003587 560 730 840 960 1010 1070DRAIN FLUID FOR CELL COUNT SVC004935 500 650 750 850 900 950DRAIN FLUID FOR CREATININE SVC004039 150 200 230 260 270 290DRAIN FLUID FOR CYTOLOGY SVC004936 510 670 770 870 920 970DRAIN FLUID FOR SODIUM SVC004888 190 250 290 330 350 370DRESSING TROLLEY SWAB SVC004818 470 620 710 800 850 900EAR SWAB FOR CULTURE & SENSITIVITY SVC003588 790 1030 1190 1350 1430 1510EBV (EA) IGG ANTIBODY SVC004040 3310 4310 4970 5630 5960 6290

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteECG MACHINE SWAB SVC004822 470 620 710 800 850 900EGFR MUTATION SVC005599 7350 9560 11030 12500 13230 13970EGFR(EXON18-21) MUTATION TESTING SVC012795 8930 11610 13400 15190 16080 16970EGFR, ALK AND ROS-1 MUTATION ANALYSIS SVC005324 12600 16380 18900 21420 22680 23940ELECTROLYTES (NA+,K+,CL+) SVC005936 480 630 720 820 870 920ELECTROLYTES (NA+,K+,CL+, HCO3-) SVC003591 480 630 720 820 870 920ENDOTRACHEAL TUBE (ET) SUCTION FOR FUNGAL CULTURE SVC004632 1550 2020 2330 2640 2790 2950ENTEROVIRUS ANTIBODIES PANEL (IGM & IGG) SVC004724 1280 1670 1920 2180 2310 2440ER/PR/HER-2 AND KI-67 SVC005941 8520 11080 12780 14490 15340 16190ERYTHROCYTE SEDIMENTATION RATE (ESR) SVC003595 170 230 260 290 310 330ET SECRETION FOR C/S SVC003597 830 1080 1250 1420 1500 1580ET SECRETION FOR GRAMS STAIN SVC003598 150 200 230 260 270 290ET SECRETIONS FUNGAL STAIN SVC003599 190 250 290 330 350 370ET SECRETIONS Z-N STAIN (AFB STAIN) SVC003600 190 250 290 330 350 370ETV6 TRANSLOCATION SVC012784 8090 10520 12140 13760 14570 15380EVD TIP FOR C/S SVC003601 470 620 710 800 850 900EXTRA SLIDE (PER SLIDE) SVC004047 600 780 900 1020 1080 1140EYE SHOWER WATER FOR C/S SVC005019 490 640 740 840 890 940EYE SWAB FOR CULTURE & SENSITIVITY SVC003603 790 1030 1190 1350 1430 1510FASTING BLOOD SUGAR (FBS) SVC003628 120 160 180 210 220 230FDP (FIBRINOGEN DEGRADATION PRODUCTS) SVC003610 1250 1630 1880 2130 2250 2380FECAL CALPROTECTIN SVC005852 3150 4100 4730 5360 5670 5990FECAL ELASTASE SVC005891 5250 6830 7880 8930 9450 9980FLOOR SWAB SVC004849 470 620 710 800 850 900FLOW CYTOMETRY FOR LEUKEMIA SVC005805 13650 17750 20480 23210 24570 25940FLT3 MOLECULAR PANEL AML SVC012709 6300 8190 9450 10710 11340 11970FLUID FOR ALBUMIN SVC004948 140 190 210 240 260 270FLUID FOR AMYLASE SVC004944 500 650 750 850 900 950FLUID FOR CHOLESTEROL SVC004055 160 210 240 280 290 310FLUID FOR CULTURE & SENSITIVITY SVC003612 880 1150 1320 1500 1590 1680FLUID FOR CYTOLOGY SVC003613 530 690 800 910 960 1010FLUID FOR FAT GLOBULES SVC004056 170 230 260 290 310 330

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteFLUID FOR GRAM STAIN SVC003614 370 490 560 630 670 710FLUID FOR LDH SVC004947 550 720 830 940 990 1050FLUID FOR LIPASE SVC004945 630 820 950 1080 1140 1200FLUID FOR TRIGLYCERIDES SVC004057 360 470 540 620 650 690FLUID IN BLOOD CULTURE BOTTLE SVC005922 1410 1840 2120 2400 2540 2680FNAC SVC003615 970 1270 1460 1650 1750 1850FOUNDATION ONE/NGS SVC011450 273000 354900 409500 464100 491400 518700FRAGILE X SYNDROME ( METHYLATION TEST - CONFIRMATORY ) SVC004510 6450 8390 9680 10970 11610 12260FREE THYROID PROFILE (FT3, FT4, TSH) SVC004753 1140 1490 1710 1940 2060 2170FREE THYROXINE (FT4) SVC003620 700 910 1050 1190 1260 1330FREE TRIIODOTHYRONINE (FT3) SVC003619 450 590 680 770 810 860FROZEN SECTION SVC004059 2200 2200 2200 2200 2200 2200FS SVC005186 6350 8260 9530 10800 11430 12070FS+ SVC005185 7060 9180 10590 12010 12710 13420FUNGAL CULTURE SVC003621 1400 1820 2100 2380 2520 2660GAMMA GLUTAMYL TRANSFERASE (GGT) SVC003626 290 380 440 500 530 560GASTRIC ASPIRATE FOR C/S SVC003624 490 640 740 840 890 940GASTRIC SECRETION FOR AFB SMEAR SVC003625 190 250 290 330 350 370GCT (GLUCOSE CHALLENGE TEST) SVC004070 110 150 170 190 200 210GENEXPERT+AFB CULTURE SVC005266 3310 4310 4970 5630 5960 6290GENOTYPING FOR HCV (IL28B) SVC004653 5080 6610 7620 8640 9150 9660GERMLINE 3 PANEL(HBOC) SVC012786 20220 26290 30330 34380 36400 38420Germline BRCA1 and BRCA2 SVC013743 19640 25540 29460 33390 35360 37320GERMLINE PANEL SVC012785 19640 25540 29460 33390 35360 37320GIARDIA LAMBILA ANTIGEN DETECTION SVC011470 710 930 1070 1210 1280 1350GLIADIN DEAMIDATED ANTIBODIES IGA SVC013361 1790 2330 2690 3050 3230 3410GLIADIN DEAMIDATED ANTIBODIES IGG SVC005573 1790 2330 2690 3050 3230 3410GLIADIN DEAMIDATED ANTIBODIEsÂ IGA & IGG SVC013362 3150 4100 4730 5360 5670 5990Glioma prognostic panel SVC013594 16800 21840 25200 28560 30240 31920GLUCOMETER RBS SVC004908 140 190 210 240 260 270GLUCOSE TOLERANCE TEST (GTT) SVC003631 170 230 260 290 310 330GLUCOSE TOLERANCE TEST(GESTATIONAL) SVC003449 300 390 450 510 540 570

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteGRAMS STAIN SMEAR SVC003633 410 540 620 700 740 780GRBS BLOOD SUGAR EMERGENCY SVC004571 50 70 80 90 90 100GROIN SWAB FOR C/S SVC003634 590 770 890 1010 1070 1130HAEMOGLOBIN (HB%) SVC003638 160 210 240 280 290 310HAEMOGLOBIN FOR FLUID SVC005396 130 170 200 230 240 250HAND DRYER AIR CULTURE SVC004810 790 1030 1190 1350 1430 1510HANGING DROP PREPARATION SVC003635 150 200 230 260 270 290HANTA VIRUS IG M ANTIBODIES SVC004078 1110 1450 1670 1890 2000 2110HBA1C SVC003632 580 760 870 990 1050 1110

HBSAG (HEPATITS B SURFACE ANTIGEN) - CHEMILUMINESCENCE SVC003640 650 850 980 1110 1170 1240HBSAG (HEPATITS B SURFACE ANTIGEN) - EIA SVC005921 560 730 840 960 1010 1070HBSAG (RAPID) SVC004775 1190 1550 1790 2030 2150 2270HBSAG (RIBA) CONFIMATORY SVC004080 4030 5240 6050 6860 7260 7660HBSAG ELFA SVC005909 740 970 1110 1260 1340 1410HCV - RIBA (HCV CONFIRMATORY) SVC004082 2920 3800 4380 4970 5260 5550HCV (ANTI HCV ANTIBODY) - CHEMILUMINESCENCE SVC003641 1860 2420 2790 3170 3350 3540HCV (ANTI HCV ANTIBODY) - EIA SVC005920 1600 2080 2400 2720 2880 3040HCV (ANTI HCV ANTIBODY) - ELISA SVC004083 1770 2310 2660 3010 3190 3370HCV (RAPID) SVC004776 1300 1690 1950 2210 2340 2470HCV ELFA SVC005911 1770 2310 2660 3010 3190 3370HDL CHOLESTROL (HDLC) SVC003642 290 380 440 500 530 560HEAVY METAL SCREEN SVC012450 5780 7520 8670 9830 10410 10990HELICOBACTER PYLORI - IGM SVC004087 1940 2530 2910 3300 3500 3690HEMOPARASITES - BY QBC METHOD SVC004090 260 340 390 450 470 500HEPARIN ANTI Xa SVC013443 9770 12710 14660 16610 17590 18570HEPARIN INDUCED THROMBOCYTOPENIA (HIT) / ANTI PLATELET FACTOR 4-HEPARIN (PF4-H), IgG QUANTITATIVE SVC013444 12500 16250 18750 21250 22500 23750HEPATITIS B SURFACE ANTIBODY(HBSAB) SVC003883 910 1190 1370 1550 1640 1730

HEPATITIS B VIRUS (HBV)HBSAG -QUANTITATIVE SURFACE ANTIGEN SVC005349 1630 2120 2450 2780 2940 3100HEPATITIS C VIRAL COMBO SVC005884 9050 11770 13580 15390 16290 17200

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HEPATITIS C VIRUS RNA (HCV RNA) QUANTITATIVE, REAL TIME PCR SVC003644 5460 7100 8190 9290 9830 10380HEPATITIS DELTA VIRUS (HDV) TOTAL ANTIBODIES SVC004092 2600 3380 3900 4420 4680 4940HEPATITS E VIRUS (HEV) QUANTITATIVE PCR SVC013638 12600 16380 18900 21420 22680 23940HISTOPATHOLOGY -LIVER BIOPSY SVC005940 2800 3640 4200 4760 5040 5320HIT ANTIBODIES (HEPARIN INDUCED THROMBOCYTOPENIA) SVC004097 2990 3890 4490 5090 5390 5690HIV - CHEMILUMINESCENCE SVC003648 620 810 930 1060 1120 1180HIV - EARLY DETECTION PANEL 1 SVC005237 2990 3890 4490 5090 5390 5690HIV - EARLY DETECTION PANEL 2 SVC005238 2480 3230 3720 4220 4470 4720HIV - EIA SVC005919 530 690 800 910 960 1010HIV (RAPID) SVC004774 1190 1550 1790 2030 2150 2270HIV 1 & 2 ANTIBODIES SVC004099 620 810 930 1060 1120 1180HIV ELFA SVC005910 590 770 890 1010 1070 1130HIV P24 ANTIGEN SVC004100 630 820 950 1080 1140 1200HIV-1 DRUG RESISTANCE GENOTYPING SVC005125 22050 28670 33080 37490 39690 41900HLA AB & DR TISSUE CROSS MATCHING SVC004104 3700 4810 5550 6290 6660 7030HLA PANEL REACTIVE IGG ANTIBODIES (PRA) SCREEN SVC005007 10050 13070 15080 17090 18090 19100HLA TISSUE TYPING SVC004102 14670 19080 22010 24940 26410 27880HLA TYPING 1ST SVC005375 7840 10200 11760 13330 14120 14900HLA TYPING 2ND SVC005376 7840 10200 11760 13330 14120 14900HLA TYPING HIGH RESOLUTION TEST SVC012780 14440 18780 21660 24550 26000 27440HLA, PRA, IGG, CLASS I & II, QUANTITATIVE SVC005414 12250 15930 18380 20830 22050 23280HPE HISTOPATHOLOGICAL EXAM SMALL SPECIMEN SVC004108 670 880 1010 1140 1210 1280HPV DNA HIGH RISK (CERVISTA) SVC005099 1660 2160 2490 2830 2990 3160HPV TESTING IN CERVICAL SMEAR SVC004109 2330 3030 3500 3970 4200 4430HTLV 1 & 11 SVC005313 6590 8570 9890 11210 11870 12530IGG SUBCLASS PANEL SVC005164 7110 9250 10670 12090 12800 13510IHC 2-3 MARKERS SVC004463 4730 6150 7100 8050 8520 8990IHC FOR C-KIT SVC004661 2100 2730 3150 3570 3780 3990IHC FOR CYTOKERATIN SVC004617 1720 2240 2580 2930 3100 3270IHC FOR VIMENTIN (J032) SVC004786 1720 2240 2580 2930 3100 3270IHC PANEL (MICROSATELLITE INSTABILITY) SVC005353 8500 11050 12750 14450 15300 16150

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteIMMUNOFLUORSCENCE - BIOPSY SVC004123 2700 3510 4050 4590 4860 5130IMMUNOHISTOCHEMISTRY, INDIVIDUAL MARKER, S100 SVC005239 1720 2240 2580 2930 3100 3270IMMUNOPHENOTYPING - 5 PANEL SVC004124 4530 5890 6800 7710 8160 8610IMMUNOPHENOTYPING - 7 PANEL SVC004125 5740 7470 8610 9760 10340 10910INDIA INK CRYPTOCOCCUS SVC003653 200 260 300 340 360 380INSTRUMENT TROLLEY SWAB SVC004850 470 620 710 800 850 900IRON PROFILE SVC011238 560 730 840 960 1010 1070IRON PROFILE: SERUM IRON, TIBC, TRANSFERRIN SATURATION SVC011303 650 850 980 1110 1170 1240IV CANNULA TIP FOR C/S SVC003659 490 640 740 840 890 940JAK2 REFLEX PANEL SVC005312 7060 9180 10590 12010 12710 13420JAK2 V617F MUTATION, QUALITATIVE PCR, LEUMETA WITH REFLEX TO EXONS12,13 SVC005114 14390 18710 21590 24470 25910 27350KAPPA/LAMBDA LIGHT CHAIN SVC004134 6830 8880 10250 11620 12300 12980KARYOTYPING SVC004023 2990 3890 4490 5090 5390 5690KI - 67 IHC SVC005276 2100 2730 3150 3570 3780 3990KIDNEY & PROSTATE CLINICÂ PKG021207 400 400 600 600 700 800KIDNEY FUNCTION EXTENDED PROFILE SVC011346 1470 1920 2210 2500 2650 2800KIDNEY FUNCTION TEST PROFILE SVC011305 1050 1370 1580 1790 1890 2000KIT MOLECULAR PANEL AML SVC012708 10500 13650 15750 17850 18900 19950KOH PREPARATION FUNGUS SVC003662 370 490 560 630 670 710KRABBE DISEASE - GALACTOCEREBROSIDASE ENZYME ASSAY SVC004561 4640 6040 6960 7890 8360 8820K-RAS GENE STUDY SVC004569 7010 9120 10520 11920 12620 13320KRAS MUTATION TESTING SVC012794 8400 10920 12600 14280 15120 15960KRAS(EXON2,EXON3) TESTING SVC012811 8820 11470 13230 15000 15880 16760LAMINAR AIR FLOW SWAB FOR C/S SVC005025 590 770 890 1010 1070 1130LDH TOTAL SVC003665 440 580 660 750 800 840LDL CHOLESTEROL SVC003666 340 450 510 580 620 650LEAD TEST SVC004137 1770 2310 2660 3010 3190 3370LEPTOSPIRA ANTIBODY (IGG AND IGM) (QUALITATIVE) SVC004665 580 760 870 990 1050 1110LEUKEMIA PANEL (FLOW CYTOMETRY) SVC005158 13130 17070 19700 22330 23640 24950LEUKEMIA/LYMPHOMA DIAGNOSTIC PANEL SVC005074 29460 38300 44190 50090 53030 55980LEUKODEPLETION FILTER FOR PLATELETS SVC004142 1280 1670 1920 2180 2310 2440

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteLEUKOVANTAGE, MYLEOID NEOPLASM MUTATION PANEL SVC005206 26460 34400 39690 44990 47630 50280LIPASE SVC003668 780 1020 1170 1330 1410 1490LIPID PROFILE (CHOL,TRIG,HDL,LDL,VLDL) SVC011235 1160 1510 1740 1980 2090 2210LIQUID BIOPSY 56 GENE TEST 56 GENES SVC006163 44100 57330 66150 74970 79380 83790LIVER ABSCESS ASPIRATE FOR C/S SVC003669 830 1080 1250 1420 1500 1580LIVER FUNCTION TEST(LFT) SVC011234 1050 1370 1580 1790 1890 2000LIVER IRON ESTIMATION SVC005054 6290 8180 9440 10700 11330 11960LYMPHOMA PANEL SVC004151 3040 3960 4560 5170 5480 5780MAGNESIUM SVC003673 630 820 950 1080 1140 1200MALARIAL ANTIGEN SVC004152 800 1040 1200 1360 1440 1520MALARIAL PARASITE ( MP ) - BY CARD METHOD SVC003674 190 250 290 330 350 370

MALARIAL PARASITE / MICROFILARIA ( MP/MF ) -BY QBC METHOD SVC003888 1620 2110 2430 2760 2920 3080MANTOUX SKIN TEST (PPD) SVC003675 270 360 410 460 490 520MCH (MEAN CORPUSCULAR HAEMOGLOBIN) SVC003677 140 190 210 240 260 270

MCHC (MEAN CORPUSCULAR HAEMOGLOBIN CONCENTRATION) SVC003678 140 190 210 240 260 270MCV (MEAN CORPUSCULAR VOLUME) SVC003679 150 200 230 260 270 290MEASLES RUBEOLA PANNAL SVC005407 5200 6760 7800 8840 9360 9880MEDIASTINAL FLUID FOR CULTURE & SENSITIVITY (C/S) SVC003682 830 1080 1250 1420 1500 1580MEDICINE TROLLEY SWAB SVC004827 470 620 710 800 850 900MENINGOENCEPHALITIS PANEL,CSF SVC004951 8770 11410 13160 14910 15790 16670METABOLIC SCREENING (TMS) SVC004668 630 820 950 1080 1140 1200METAL SCREEN 2 WHOLE BLOOD SVC011860 11550 15020 17330 19640 20790 21950METHAEMOGLOBIN SVC004158 390 510 590 670 710 750METHYL MALONIC ACID SVC005242 1820 2370 2730 3100 3280 3460METHYLGUANINE METHYLTRANSFERASE (MGMT) SVC005249 17640 22940 26460 29990 31760 33520MICROSATELLITE INSTABILITY INDEX BY IHC SVC012809 7720 10040 11580 13130 13900 14670MICROSATELLITE INSTABILITY INDEX BY PCR SVC012810 12130 15770 18200 20630 21840 23050MIXING STUDY (PT OR PTT) SVC004872 3310 4310 4970 5630 5960 6290MOLECULAR PANEL AML SVC012707 14700 19110 22050 24990 26460 27930MOLECULAR PANEL FOR B-ALL SVC012695 17850 23210 26780 30350 32130 33920

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteMOLECULAR PANEL FOR CML SVC012751 17850 23210 26780 30350 32130 33920MOLECULAR PANEL FOR ETP-ALL(FLT3-ITD AND D835) SVC012696 6300 8190 9450 10710 11340 11970MOLECULAR TEST HCL (BRAFV600E MUTATION) SVC012758 6300 8190 9450 10710 11340 11970MONITOR SWAB SVC004815 470 620 710 800 850 900MPN PANEL WITH BCR-ABL1: SVC012774 19430 25260 29150 33040 34980 36920MTB RAPID IDENTIFICATION SVC005372 370 490 560 630 670 710MUSCLE BIOPSY(HISTOPATHOLOGY) SVC003447 2210 2880 3320 3760 3980 4200MYCOBACTERIUM TUBERCULOSIS ANTIBODY IGA SVC004166 1020 1330 1530 1740 1840 1940MYCOBACTERIUM TUBERCULOSIS ANTIBODY IGM SVC003684 1440 1880 2160 2450 2600 2740MYD88(L265P) SVC012761 6300 8190 9450 10710 11340 11970NAIL CLIPPING FUNGAL CULTURE SVC003685 1290 1680 1940 2200 2330 2460NAIL CLIPPING KOH PREPARATION SVC003686 210 280 320 360 380 400NASAL SWAB FOR C/S SVC003687 970 1270 1460 1650 1750 1850

NEWBORN SCREENING, EXTENDED BIOTINIDASE CYSTIC FIBROSIS SVC004178 4360 5670 6540 7420 7850 8290NIPPLE DISCHARGE FOR CYTOLOGY SVC004671 610 800 920 1040 1100 1160NITROBLUE TETRAZOLIUM SVC004180 1880 2450 2820 3200 3390 3580NOCARDIA, STAIN SVC005490 410 540 620 700 740 780NON MYCOBACTERIUM TUBERCULOSIS PCR SVC005216 2990 3890 4490 5090 5390 5690NONSMALL CELL LUNG CANCER(ALK+EGFR) SVC012792 12600 16380 18900 21420 22680 23940NONSMALL CELL LUNG CANCER(EGFR+ KRAS) SVC012793 15750 20480 23630 26780 28350 29930NRAS(EXON2,EXON3) TESTING SVC012812 8820 11470 13230 15000 15880 16760NSCLC NGS PANEL-1(FFPE) SVC012798 31500 40950 47250 53550 56700 59850NT PRO BNP SVC005672 4190 5450 6290 7130 7550 7970NTRK3 TRANSLOCATION SVC012783 8090 10520 12140 13760 14570 15380ORAL ULCER SWAB FOR C/S SVC003690 490 640 740 840 890 940OT LAMP SWAB SVC004852 470 620 710 800 850 900OT TABLE SWAB SVC004853 470 620 710 800 850 900PANCA SVC003691 1890 2460 2840 3220 3410 3600PAP SMEAR SVC003692 720 940 1080 1230 1300 1370PARATHYROID HORMONE (PTH) SVC003735 1950 2540 2930 3320 3510 3710PARATHYROID HORMONE RELATED PROTEIN SVC013301 12550 16320 18830 21340 22590 23850

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuitePATIENT TROLLEY SWAB SVC004830 470 620 710 800 850 900PCOD PANEL SVC003693 3430 4460 5150 5840 6180 6520PCR FOR EU BACTERIAL - QUALITATIVE SVC004190 2380 3100 3570 4050 4290 4530PCR FOR HBV DNA -QUANTIFICATION SVC003695 9100 11830 13650 15470 16380 17290PCR FOR HCV RNA - QUANTIFICATION SVC004192 33080 43010 49620 56240 59550 62860PCR FOR HIV - QUALITATIVE SVC004193 4190 5450 6290 7130 7550 7970PCR FOR HSV - QUANTIFICATION SVC004195 4910 6390 7370 8350 8840 9330PCV (PACKED CELL VOLUME) / HEMATOCRIT SVC003696 180 240 270 310 330 350PDL1 TEST BY IHC(DAKO PLATFORM) SVC012797 11550 15020 17330 19640 20790 21950PDL1 TEST BY IHC(ROCHE VENTANNA PLATFORM) SVC012796 8400 10920 12600 14280 15120 15960

PERICARDIAL FLUID - CLINICAL PATHOLOGY, CELL COUNT & CELL TYPE SVC003697 450 590 680 770 810 860PERICARDIAL FLUID AFB CULTURE FOR (BACTEC METHOD) SVC004201 1550 2020 2330 2640 2790 2950PERICARDIAL FLUID FOR AFB STAIN SVC003698 190 250 290 330 350 370PERICARDIAL FLUID FOR ANALYSIS (BIOCHEMISTRY) SVC003699 490 640 740 840 890 940PERICARDIAL FLUID FOR CELL COUNT SVC004929 490 640 740 840 890 940PERICARDIAL FLUID FOR CULTURE AND SENSITIVITY SVC003700 1220 1590 1830 2080 2200 2320PERICARDIAL FLUID FOR CYTOLOGY/MALIGNANT CELLS SVC003701 530 690 800 910 960 1010PERICARDIAL FLUID FOR GRAMS STAIN SVC003702 150 200 230 260 270 290PERICARDIAL FLUID FOR TB - PCR SVC004202 2820 3670 4230 4800 5080 5360PERIPHERAL BLOOD STEM CELL COLLECTION (PBSC) WITH CRYOPRESERVATION SVC004317 29990 38990 44990 50990 53990 56990PERIPHERAL SMEAR EXAMINATION SVC003705 190 250 290 330 350 370PERIPHERAL SMEAR FOR MP & MF SVC003706 170 230 260 290 310 330PERITONEAL / ASCITIC FLUID - CLINICAL PATHOLOGY SVC004204 180 240 270 310 330 350PERITONEAL / ASCITIC FLUID- BIOCHEMISTRY SVC003713 520 680 780 890 940 990PERITONEAL DAILYSIS FLUID ANALYSIS SVC005043 760 990 1140 1300 1370 1450PERITONEAL FLUID AFB STAIN/ ZN STAIN SVC003707 200 260 300 340 360 380PERITONEAL FLUID FOR AFB CULTURE (BACTEC METHOD) SVC004205 1220 1590 1830 2080 2200 2320PERITONEAL FLUID FOR ANAEROBIC C/S SVC004203 1110 1450 1670 1890 2000 2110PERITONEAL FLUID FOR FUNGAL CULTURE SVC003709 1170 1530 1760 1990 2110 2230PERITONEAL FLUID FOR FUNGAL STAIN SVC003710 190 250 290 330 350 370

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuitePERITONEAL FLUID FOR GRAM STAIN SVC003711 180 240 270 310 330 350PERITONEAL FLUID/ ASCITIC FLUID FOR C/ S SVC003712 830 1080 1250 1420 1500 1580PERITONEAL/ ASCITIC FLUID FOR CYTOLOGY SVC003708 1010 1320 1520 1720 1820 1920PERL'S/IRON STAINING- BONE MARROW SVC005096 480 630 720 820 870 920PHENOL SVC013634 2100 2730 3150 3570 3780 3990

PHOSPHOLIPID SYNDROME PANEL (CARDIOLIPIN ANTIBODIES IGG & IGM, PHOSPHOLIPID ANTIBODIES, LUPUS ANTICOAGULANT) SVC004566 4730 6150 7100 8050 8520 8990PHOSPHORUS SVC003716 200 260 300 340 360 380PIK3CA mutation analysis SVC012451 10500 13650 15750 17850 18900 19950PLASMA BATH SWAB FOR C/S SVC005031 590 770 890 1010 1070 1130PLASMA FREE HAEMOGLOBIN SVC004208 200 260 300 340 360 380PLATELET COUNT SVC003717 70 100 110 120 130 140PLATELET FUNCTION TEST SVC004211 5350 6960 8030 9100 9630 10170PLATELET RICH PLASMA SVC004212 1410 1840 2120 2400 2540 2680PLATELET SCREEN SVC005277 200 260 300 340 360 380PLATELETS AGGITATOR SWAB FOR C/S SVC005028 490 640 740 840 890 940PLEURAL FLUID ANALYSIS (CLINICAL PATHOLOGY) SVC003719 1000 1300 1500 1700 1800 1900PLEURAL FLUID FOR CULTURE & SENSITIVITY SVC003720 970 1270 1460 1650 1750 1850PLEURAL FLUID FOR CYTOLOGY SVC003721 720 940 1080 1230 1300 1370PLEURAL FLUID FOR CYTOLOGY/MALIGNANT CELLS SVC004965 600 780 900 1020 1080 1140PLEURAL FLUID FOR FUNGAL CULTURE SVC003722 1220 1590 1830 2080 2200 2320PLEURAL FLUID FOR FUNGAL STAIN SVC003723 200 260 300 340 360 380PLEURAL FLUID FOR GRAM STAIN SVC003724 210 280 320 360 380 400PLEURAL FLUID FOR Z-N STAIN ( AFB STAIN) SVC003725 350 460 530 600 630 670

PLEURAL FLUID ROUTINE ANALYSIS (CELL COUNT AND BIOCHEMISTRY) SVC004949 950 1240 1430 1620 1710 1810POST- BMT CASE CONVENTIONAL KARYOTYPING(BONE MARROW TRANSPLANT) SVC012777 5250 6830 7880 8930 9450 9980POST PRANDIAL BLOOD SUGAR (PPBS) SVC003629 120 160 180 210 220 230

POST SEX-MISMATCHED BONE MARROW TRANSPLANT MONITORING SVC012775 10500 13650 15750 17850 18900 19950

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuitePOST SURGICAL HAND SCRUB SWAB FOR C/S SVC005018 590 770 890 1010 1070 1130POTASSIUM, SERUM SVC003728 210 280 320 360 380 400PRE OP PROFILE-1 SVC011343 5360 6970 8040 9120 9650 10190PRE OP PROFILE-2 SVC011342 6410 8340 9620 10900 11540 12180PRE OPERATIVE (CABG) PROFILE SVC011334 6200 8060 9300 10540 11160 11780PRE OPERATIVE (PAEDIATRIC)(CTVS) PROFILE SVC011331 5740 7470 8610 9760 10340 10910PRE OPERATIVE (VALVE) PROFILE SVC011333 5790 7530 8690 9850 10430 11010PRIMARY IMMUNODEFICIENCY PANEL(CD3, CD4, CD8, CD19, CD16, CD56, CD45) SVC004802 8280 10770 12420 14080 14910 15740PROCALCITONIN (PCT) SVC004220 6180 8040 9270 10510 11130 11750PROSTATE SPECIFIC ANTIGEN (PSA) SVC003733 970 1270 1460 1650 1750 1850PROSTATIC SECRETION FOR CYTOLOGY SVC004684 270 360 410 460 490 520PT - INR (PROTHROMBIN TIME) SVC003734 480 630 720 820 870 920PTT (ACTIVATED THROMBOPLASTIN TIME) SVC003736 630 820 950 1080 1140 1200PUS FOR ANAEROBIC C/S SVC003737 1550 2020 2330 2640 2790 2950PUS FOR CULTURE & SENSITIVITY SVC003738 920 1200 1380 1570 1660 1750PUS FOR FUNGAL CULTURE SVC003739 1220 1590 1830 2080 2200 2320PUS FOR FUNGAL STAIN SVC003740 230 300 350 400 420 440PUS FOR GRAM STAIN SVC003741 210 280 320 360 380 400PUS FOR Z-N STAIN (AFB STAIN) SVC003742 230 300 350 400 420 440PUS FROM LUNG ABSCESS FOR C/S SVC003744 490 640 740 840 890 940QUALITATIVE ANALYSIS FOR PML-RARA SVC012711 6300 8190 9450 10710 11340 11970RABIES ANTIBODIES SVC004227 2430 3160 3650 4140 4380 4620RANDOM BLOOD SUGAR (RBS) SVC003630 110 150 170 190 200 210RANDOM URINE CALCIUM SVC003746 280 370 420 480 510 540RANDOM URINE CHLORIDE SVC003747 290 380 440 500 530 560RANDOM URINE CREATININE SVC003748 290 380 440 500 530 560RANDOM URINE FOR CALCIUM-CREATININE RATIO SVC004471 530 690 800 910 960 1010RANDOM URINE FOR PROTEIN SVC004709 280 370 420 480 510 540RANDOM URINE MAGNESIUM SVC004229 1260 1640 1890 2150 2270 2400RANDOM URINE PHOSPHOROUS SVC003749 280 370 420 480 510 540RANDOM URINE POTASSIUM SVC004231 300 390 450 510 540 570

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteRANDOM URINE SODIUM SVC004232 330 430 500 570 600 630RANDOM URINE UREA NITROGEN SVC004326 280 370 420 480 510 540RANDOM URINE URIC ACID SVC003750 280 370 420 480 510 540RAPID PLASMA REAGIN -CSF(RPR) SVC005156 280 370 420 480 510 540RAPID PLASMA REAGIN -SERUM(RPR) SVC005155 350 460 530 600 630 670RED BLOOD CELL COUNT SVC003752 140 190 210 240 260 270RED CELL DISTRIBUTION WIDTH (RDW) SVC005180 90 120 140 160 170 180RENAL PACKAGE - 1 SVC011240 650 850 980 1110 1170 1240RENAL PACKAGE - 2 SVC011381 1160 1510 1740 1980 2090 2210RESPIRATORY COMPREHENSIVE PANEL SVC005619 15750 20480 23630 26780 28350 29930RESPIRATORY PCR PANEL I SVC005227 7060 9180 10590 12010 12710 13420RETICULOCYTE COUNT SVC003755 470 620 710 800 850 900RHEUMATOID FACTOR -SERUM SVC003756 550 720 830 940 990 1050RHEUMATOID FACTOR- SYNOVIAL FLUID SVC003757 500 650 750 850 900 950ROTA VIRUS ANTIGEN DETECTION SVC005004 1110 1450 1670 1890 2000 2110RT-QPCR FOR BCR-ABL1 TRANSCRIPT COPIES(IS), QUANTITATIVE ANALYSIS SVC012752 7880 10250 11820 13400 14190 14980RT-QPCR FOR PML-RARA TRANSCRIPT QUANTITAIVE ANALYSIS SVC012712 18900 24570 28350 32130 34020 35910

RT-QPCR FOR PML-RARA TRANSCRIPT QUANTITAIVE ANALYSIS(BCR1) SVC012713 7140 9290 10710 12140 12860 13570

RT-QPCR FOR PML-RARA TRANSCRIPT QUANTITAIVE ANALYSIS(BCR3) SVC012714 7140 9290 10710 12140 12860 13570SABACEOUS - CYST FOR HISTOPATHOLOGY SVC004242 390 510 590 670 710 750SEMEN ANALYSIS SVC003761 590 770 890 1010 1070 1130SEMEN FOR C/S SVC003762 880 1150 1320 1500 1590 1680SEROLOGY PROFILE SVC011237 2140 2790 3210 3640 3860 4070SERUM ALBUMIN SVC003763 170 230 260 290 310 330SERUM AMYLASE SVC003764 520 680 780 890 940 990SERUM ASCITES ALBUMIN GRADIENT (SAAG) SVC004687 360 470 540 620 650 690SERUM CREATININE SVC003759 190 250 290 330 350 370SERUM FERRITIN SVC003768 950 1240 1430 1620 1710 1810SERUM GLOBULIN SVC003769 210 280 320 360 380 400

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteSERUM INSULIN SVC004250 890 1160 1340 1520 1610 1700SERUM OSMOLALITY (CALCULATED) SVC003776 890 1160 1340 1520 1610 1700SERUM OSMOLALITY (MEASURED) SVC005117 450 590 680 770 810 860SERUM PARACETAMOL SVC004728 1280 1670 1920 2180 2310 2440SERUM PHYTANIC ACID SVC005228 5240 6820 7860 8910 9440 9960SERUM RPR SVC005317 200 260 300 340 360 380SERUM TIBC SVC003777 590 770 890 1010 1070 1130SERUM TRANSFERRIN SVC003882 1220 1590 1830 2080 2200 2320SES - SEPSIS WITH ANTIBIOTIC RESISTANCE SVC005088 20630 26820 30950 35080 37140 39200SES RNA VIRUS SVC004892 12250 15930 18380 20830 22050 23280SEX-MISMATCHED BONE MARROW TRANSPLANT MONITORING SVC012776 5250 6830 7880 8930 9450 9980SGOT (AST) SVC003778 210 280 320 360 380 400SGPT (ALT) SVC003779 210 280 320 360 380 400SICKLING TEST SVC003780 180 240 270 310 330 350SINGLE 8 COLOR SCREENING PANEL (FLOW CYTOMETRIC IMMUNOPHENOTYPING) SVC005123 3360 4370 5040 5720 6050 6390SINGLE ANTIGEN TEST SVC005209 17200 22360 25800 29240 30960 32680SINGLE BLOOD BAG STERILITY TEST SVC004842 740 970 1110 1260 1340 1410SINGLE MUTATION CONFIRMATION TEST SVC005130 2550 3320 3830 4340 4590 4850SINGLE PROTOCOL (FLOW CYTOMETRY) SVC005531 3310 4310 4970 5630 5960 6290SKIN FIBROBLAST CHROMOSOME ANALYSIS (CYTOGENETICS) SVC004790 4580 5960 6870 7790 8250 8710SKIN SCRAPING FOR FUNGAL CULTURE SVC003782 1160 1510 1740 1980 2090 2210SKIN SCRAPPING FOR KOH PREPARATION SVC004259 140 190 210 240 260 270SLIT SKIN SMEAR FOR M.LEPRAE SVC004262 270 360 410 460 490 520SM (SMITH) ANTIBODY, IGG SVC005902 1020 1330 1530 1740 1840 1940SODIUM, SERUM SVC003784 210 280 320 360 380 400SPUTUM FOR AFB (ZN STAIN) SVC003785 370 490 560 630 670 710SPUTUM FOR CULTURE AND SENSITIVITY SVC003786 920 1200 1380 1570 1660 1750SPUTUM FOR CYTOLOGY SVC004696 370 490 560 630 670 710SPUTUM FOR FUNGAL CULTURE SVC003787 1340 1750 2010 2280 2420 2550SPUTUM FOR MALIGNANT CELLS SVC003788 510 670 770 870 920 970SPUTUM FOR MYCOBACTERIAL CULTURE - (BACTEC METHOD) SVC004265 1110 1450 1670 1890 2000 2110

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteSPUTUM FOR PCP SVC004266 2650 3450 3980 4510 4770 5040SPUTUM FOR TBPCR SVC004695 2430 3160 3650 4140 4380 4620SPUTUM FUNGAL STAIN SVC003789 230 300 350 400 420 440SPUTUM GRAM STAIN SVC003790 440 580 660 750 800 840STERILE ROOM SWAB RACK SVC004862 470 620 710 800 850 900STERILITY CHECK SVC005046 1110 1450 1670 1890 2000 2110STERNAL SWAB FOR C/S SVC003792 490 640 740 840 890 940STOOL (OCCULT BLOOD) SVC003794 190 250 290 330 350 370STOOL CULTURE & SENSITIVITY SVC003795 860 1120 1290 1470 1550 1640STOOL FOR CRYPTOSPORIDIUM/ISOSPORA IDENTIFICATION SVC004997 350 460 530 600 630 670STOOL FOR PH SVC004697 190 250 290 330 350 370STOOL REDUCING SUBSTANCES SVC003796 170 230 260 290 310 330STOOL ROUTINE EXAMINATION SVC003797 160 210 240 280 290 310STR CHIMERISM ANALYSIS SVC012779 10500 13650 15750 17850 18900 19950STRAND CUSTOM GENE TEST SVC005129 33640 43740 50460 57190 60560 63920STRAND GERMLINE CANCER TEST - COMPREHENSIVE SVC005126 16880 21950 25320 28700 30390 32080STRAND X - RARE DISEASES INHERITED PANEL TEST SVC005012 23160 30110 34740 39380 41690 44010SUCTION TIP FOR C/S SVC003800 620 810 930 1060 1120 1180SUDAN IV STAIN SVC013427 580 760 870 990 1050 1110SWAB CULTURE PROFILE - NH OT SVC011251 740 970 1110 1260 1340 1410SWAB CULTURE PROFILE - NURSING STATION SVC011252 710 930 1070 1210 1280 1350SWAB CULTURE PROFILE - PROCEDURE ROOM SVC005040 590 770 890 1010 1070 1130SWAB CULTURE PROFILE - RECOVERY ROOM SVC005039 490 640 740 840 890 940SWAB FOR CULTURE SVC003801 970 1270 1460 1650 1750 1850SYNOVIAL FLUID FOR ANALYSIS (BIO) SVC003803 1070 1400 1610 1820 1930 2040SYNOVIAL FLUID FOR ANALYSIS (CLINICAL PATHOLOGY) SVC004269 950 1240 1430 1620 1710 1810SYNOVIAL FLUID FOR CULTURE & SENSITIVITY SVC003804 660 860 990 1130 1190 1260SYNOVIAL FLUID FOR CYTOLOGY SVC003805 1050 1370 1580 1790 1890 2000SYNOVIAL FLUID FOR FUNGAL STAIN SVC004698 130 170 200 230 240 250SYNOVIAL FLUID FOR GRAM STAIN SVC003807 200 260 300 340 360 380SYNOVIAL FLUID FOR TB - PCR SVC004270 3360 4370 5040 5720 6050 6390SYNOVIAL FLUID FOR ZN STAIN (AFB) SVC003808 210 280 320 360 380 400

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteTACROLIMUS (SAMPLE 5 AND ABOVE) SVC004962 3260 4240 4890 5550 5870 6200TBÂ GOLD PLUS INTERFERON GAMMA RELEASE ASSAY (IGRA) SVC013735 2940 3830 4410 5000 5300 5590TC & DC SVC003810 190 250 290 330 350 370TCR ALPHA BETA & CD19 DEPLETION SVC005056 12250 15930 18380 20830 22050 23280TEC (TOTAL EOSINOPHIL COUNT) SVC003885 200 260 300 340 360 380THERAPEUTIC PHLEBOTOMY SVC004699 170 230 260 290 310 330THROAT SWAB FOR ALBERTS STAIN SVC003813 280 370 420 480 510 540THROAT SWAB FOR CULTURE & SENSITIVITY SVC003814 970 1270 1460 1650 1750 1850THROMBIN TIME SVC003815 780 1020 1170 1330 1410 1490THROMBOELASTOGRAM (TEG) SVC004759 9200 9200 12000 13800 15700 17500THYROID PROFILE (T3, T4, TSH) SVC003809 690 900 1040 1180 1250 1320THYROXINE (T4) SVC004272 260 340 390 450 470 500TISSUE FOR C/S SVC003816 970 1270 1460 1650 1750 1850TISSUE FOR FUNGAL STAIN SVC004879 170 230 260 290 310 330TISSUE FOR GRAM STAIN SVC004882 210 280 320 360 380 400TISSUE FOR Z-N STAIN SVC004877 530 690 800 910 960 1010TONGUE SWAB FOR CULTURE & SENSITIVITY SVC003817 490 640 740 840 890 940TOTAL COUNT (TC) SVC003811 160 210 240 280 290 310TOTAL IRON SVC003657 560 730 840 960 1010 1070TOTAL PROTEIN SVC003819 210 280 320 360 380 400TPMT GENOTYPING SVC012698 6300 8190 9450 10710 11340 11970TRACHEAL ASPIRATION FOR C/S SVC003822 830 1080 1250 1420 1500 1580TRACHEOSTOMY SECRETIONS FOR C/S SVC003823 560 730 840 960 1010 1070TRACHEOSTOMY SWAB FOR C/S SVC003824 490 640 740 840 890 940TRANSFERRIN SATURATION SVC004808 1100 1430 1650 1870 1980 2090TRANSFUSION PACKED CELLS SVC004315 340 450 510 580 620 650TRANSFUSION PLATELET SVC004316 230 300 350 400 420 440TRANSFUSION REACTION PATIENT CULTURE SVC004839 740 970 1110 1260 1340 1410TRANSFUSION TRANSMISSIBLE INFECTIONS (TTI) SVC004703 1440 1880 2160 2450 2600 2740TRI IODO THYRONINE (T3) SVC004271 230 300 350 400 420 440TRIGLYCERIDES SVC003825 360 470 540 620 650 690TRIPLE BLOOD BAG STERILITY TEST SVC004845 740 970 1110 1260 1340 1410

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteTROPHOBLASTIC CANCER MARKER-BETA HCG SVC004452 630 820 950 1080 1140 1200TROPONIN I SVC003826 1950 2540 2930 3320 3510 3710TSH (THYROID STIMULATING HORMONE) SVC003827 500 650 750 850 900 950TSH RECEPTOR ANTIBODY (IGG) SVC004702 6570 8550 9860 11170 11830 12490TYPE & SCREEN (TS) SVC005452 270 360 410 460 490 520TYPHI DOT IGM SVC005165 590 770 890 1010 1070 1130TYPHIDOT SVC004873 570 750 860 970 1030 1090TZANCK SMEAR SVC004283 240 320 360 410 440 460

UGT1A1 GENE POLYMORPHISM (NUCLEOTIDE TA REPEATS) DETECTION SVC005450 5780 7520 8670 9830 10410 10990UREA, SERUM SVC004964 170 230 260 290 310 330URIC ACID SVC003833 210 280 320 360 380 400URINE / PLASMA DARK FIELD MICROSCOPY FOR LEPTOSPIRA SVC004284 130 170 200 230 240 250URINE EXAMINATION (ROUTINE) SVC004957 130 170 200 230 240 250URINE FOR AFB SMEAR SVC003834 230 300 350 400 420 440URINE FOR ALBUMIN SVC003835 190 250 290 330 350 370URINE FOR AMINO ACIDO GRAM SVC004286 8880 11550 13320 15100 15990 16880URINE FOR AMYLASE SVC005179 560 730 840 960 1010 1070URINE FOR BS/BP (BILE SALT & BILE PIGMENT) SVC003838 180 240 270 310 330 350URINE FOR CULTURE & SENSITIVITY SVC003839 900 1170 1350 1530 1620 1710URINE FOR CYTOLOGY SVC004705 960 1250 1440 1640 1730 1830URINE FOR CYTOLOGY /MALIGNANT CELLS SVC003840 520 680 780 890 940 990URINE FOR EOSINOPHILS SVC004288 190 250 290 330 350 370URINE FOR FAT GLOBULES SVC004289 50 70 80 90 90 100URINE FOR FUNGAL CULTURE SVC003841 1170 1530 1760 1990 2110 2230URINE FOR FUNGAL STAIN SVC003842 230 300 350 400 420 440URINE FOR GRAM STAIN SVC003843 180 240 270 310 330 350URINE FOR HAEMOGLOBIN SVC003844 210 280 320 360 380 400URINE FOR KETONE BODIES SVC003845 160 210 240 280 290 310URINE FOR LEGIONELLA ANTIGEN SVC005438 2520 3280 3780 4290 4540 4790URINE FOR MYOGLOBIN SVC004292 1070 1400 1610 1820 1930 2040URINE FOR PH SVC004293 190 250 290 330 350 370

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteURINE FOR PREGNANCY TEST SVC003847 230 300 350 400 420 440URINE FOR PROTEIN (SPOT) SVC004923 130 170 200 230 240 250URINE FOR PROTIEN ELECTROPHORESIS SVC004295 4100 5330 6150 6970 7380 7790URINE FOR REDUCING SUBSTANCES SVC003848 140 190 210 240 260 270URINE FOR SODIUM (24-HOURS) SVC004718 300 390 450 510 540 570URINE FOR SPECIFIC GRAVITY SVC004296 150 200 230 260 270 290URINE FOR SUGAR SVC003849 80 110 120 140 150 160URINE FOR SUGAR (FASTING) SVC003850 80 110 120 140 150 160URINE FOR SUGAR (POST PRANDIAL) SVC003851 80 110 120 140 150 160URINE FOR SUGAR (RANDOM) SVC003852 90 120 140 160 170 180URINE FOR ZN STAIN SVC004707 130 170 200 230 240 250URINE KETONE STRIPS SVC004751 170 230 260 290 310 330URINE MPS ELECTROPHORESIS SVC004968 1600 2080 2400 2720 2880 3040URINE PORPHYRIA - RANDOM / 24 HRS. SVC004298 3700 4810 5550 6290 6660 7030URINE POTASSIUM (RANDOM) SVC003856 300 390 450 510 540 570URINE PROTEIN TO CREATININE RATIO SVC003857 560 730 840 960 1010 1070URINE ROUTINE & MICROSCOPY SVC003858 200 260 300 340 360 380URINE ROUTINE WITHOUT MICROSCOPY (INSTANT) SVC004766 360 470 540 620 650 690VACUOLATED EOSINOPHIL COUNT SVC003859 140 190 210 240 260 270VAGINAL SWAB FOR C/S SVC003860 970 1270 1460 1650 1750 1850VDRL- CSF SVC003861 260 340 390 450 470 500VDRL -SERUM SVC003862 210 280 320 360 380 400VENOUS BLOOD GAS-NON LAB SVC004996 970 1270 1460 1650 1750 1850VIRAL PANEL FOR TRANSPLANT SVC005060 8770 11410 13160 14910 15790 16670VITAMIN B-12 SVC003863 1370 1790 2060 2330 2470 2610VITAMIN D 25 HYDROXY SVC003864 2310 3010 3470 3930 4160 4390VITAMIN D 25 HYDROXY (VITAMIN D TOTAL) SVC004320 2000 2600 3000 3400 3600 3800VITREOUS FLUID FOR FUNGAL STAIN SVC003868 190 250 290 330 350 370VLDL CHOLESTEROL SVC003870 280 370 420 480 510 540VNTR CHIMERISM ANALYSIS SVC012778 8400 10920 12600 14280 15120 15960WALL SWAB SVC004861 470 620 710 800 850 900WATER FOR CULTURE SVC003871 1160 1510 1740 1980 2090 2210

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteWBC COUNT SVC004863 140 190 210 240 260 270WHOLE BLOOD CULTURE SVC004832 740 970 1110 1260 1340 1410WHOLE BLOOD FOR ALCD AND MRD SVC004480 890 1160 1340 1520 1610 1700WHOLE BLOOD FOR SEROLIMUS (RAPAMYCIN) SVC004792 5080 6610 7620 8640 9150 9660WIDAL TEST SVC003873 330 430 500 570 600 630WOUND SWAB - HAND FOR C/S SVC003875 490 640 740 840 890 940WOUND SWAB FOR AFB STAIN SVC003877 190 250 290 330 350 370WOUND SWAB FOR CULTURE & SENSITIVITY SVC003878 960 1250 1440 1640 1730 1830WOUND SWAB FOR FUNGAL STAIN SVC004712 130 170 200 230 240 250WOUND SWAB FOR GRAM STAIN SVC003879 180 240 270 310 330 350XYTON FOR ENCEPHALITIS PCR SVC004311 14120 18360 21180 24010 25420 26830

17 - HYDROXYPROGESTERONE, NEWBORN SCREEN; CAH SCREEN SVC003891 260 390 390 390 390 39017 ALPHA HYDROXY PROGESTERONE SVC003892 1310 1970 1970 1970 1970 197017-HYDROXY PROGESTERON SVC005355 1450 2180 2180 2180 2180 218024 HOURS URINE FOR 5HIAA SVC003894 2780 4170 4170 4170 4170 417024 HOURS URINE FOR CATECHOLAMINES SVC003451 4730 7090 7090 7090 7090 709024 HOURS URINE FOR CHROMIUM SVC005344 3360 5040 5040 5040 5040 504024 HOURS URINE FOR CITRATE SVC003899 920 1380 1380 1380 1380 138024 HOURS URINE FOR COPPER SVC003452 1850 2780 2780 2780 2780 278024 HOURS URINE FOR CORTISOL SVC003895 840 1260 1260 1260 1260 126024 HOURS URINE FOR METANEPHRINES SVC003896 6000 6000 6000 6000 6000 600024 HOURS URINE FOR MICROALBUMIN SVC003457 580 870 870 870 870 87024 HOURS URINE FOR OXALATE SVC003897 1790 2690 2690 2690 2690 269024 HOURS URINE FOR VMA SVC003898 3680 5510 5510 5510 5510 55102-HOURS POSTLOAD (75 GM) GLUCOSE SVC004467 170 250 250 250 250 250Â NEISSERIA GONORRHEA QUALITATIVE PCR SVC013941 3500 3500 3500 3500 3500 3500ACE (ANGIOTENSIN CONVERTING ENZYME) SVC003465 1160 1740 1740 1740 1740 1740ACETYL CHOLINE RECEPTOR ANTIBODIES (ACHR ABS) SVC003905 2260 3390 3390 3390 3390 3390ACHR BLOCKING ANTIBODY SVC004576 10400 15590 15590 15590 15590 15590ACID PHOSPHATASE SVC003906 180 270 270 270 270 270

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ACUTE LEUKEMIA COMPREHENSIVE DIAGNOSTIC PANEL (ALCD PANEL) SVC004450 26250 39380 39380 39380 39380 39380ACUTE MYELOID LEUKEMIA ONCOINSIGHTS COMBI-PANEL AML SVC006031 29500 29500 29500 29500 29500 29500ADA (ADENOSINE DEAMINASE - BODY FLUID) SVC003908 960 1440 1440 1440 1440 1440ADENO VIRUS PCR SVC003910 4200 6300 6300 6300 6300 6300ADENOSINE DEAMINASE SVC003467 690 1040 1040 1040 1040 1040ADENOSINE DEAMINASE(ADA) - CSF SVC004755 630 950 950 950 950 950ADRENOCORTICOTROPIC HORMONE (ACTH) SVC003466 1550 2330 2330 2330 2330 2330AFB CULTURE & RADIOMETRIC SUSCEPTIBILITY - 10 DRUG PANEL SVC003911 10030 15040 15040 15040 15040 15040AFB CULTURE & RADIOMETRIC SUSEPTIBILITY - 15 DRUG PANEL SVC004980 12810 19220 19220 19220 19220 19220AFB CULTURE & RADIOMETRIC SUSEPTIBILITY - 5 DRUG PANEL SVC003469 6350 9530 9530 9530 9530 9530AFB CULTURE/MYCOBACTERIAL CULTURE (BACTEC METHOD) SVC003470 1850 2780 2780 2780 2780 2780AFB CULTURE/MYCOBACTERIAL CULTURE (LJ METHOD) SVC003471 1210 1810 1810 1810 1810 1810AFB -MOTT ANTIBIOGRAAM PANEL FOR RAPID GROWERS UPTO 10 DRUGS SVC005264 6410 9610 9610 9610 9610 9610ALDOLASE SVC003918 720 1090 1090 1090 1090 1090ALDOSTERONE SVC003919 1600 2400 2400 2400 2400 2400ALDOSTERONE / PLASMA RENIN DIRECT RATIO SVC004793 7040 10550 10550 10550 10550 10550ALLERGY FOOD PANEL2 SVC005684 8250 8250 8250 8250 8250 8250ALLERGY MARKER-ASPERGILLUS FUMIGATUS SVC004337 1160 1730 1730 1730 1730 1730ALLERGY-WHEEZE / RHINITIS PANEL,PEDIATRIC SVC004444 11030 16540 16540 16540 16540 16540ALPHA - 1 ANTITRYPSIN SVC003920 1940 2910 2910 2910 2910 2910ALPHA - 1 ANTITRYPSIN PHENOTYPE SVC003921 7720 11580 11580 11580 11580 11580ALPHA FETO PROTEIN (AFP) SVC003473 920 1380 1380 1380 1380 1380ALPHA THALASSEMIA MUTATION ANALYSIS BY DNA-PCR SVC004864 2730 4100 4100 4100 4100 4100AMINO ACID ASSAY-QUANTITATIVE( HPLC ) SVC004562 5990 8980 8980 8980 8980 8980AMMONIA (PLASMA) SVC003889 1160 1740 1740 1740 1740 1740AMOEBIC SEROLOGY (ENTAMOEBA HISTOLYTICA ANTIBODIES) SVC003924 1950 2930 2930 2930 2930 2930ANAEROBIC CULTURE SVC003925 1260 1890 1890 1890 1890 1890ANCA (P/C) SVC003476 1870 2810 2810 2810 2810 2810ANTI - CARDIOLIPIN ANTIBODY (ANTI - PHOSPHOLIPID) IGM SVC003927 820 1230 1230 1230 1230 1230ANTI - GBM ANTIBODIES SVC003928 1520 2280 2280 2280 2280 2280

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteANTI B TITRE,IGG SVC006091 1000 1000 1000 1000 1000 1000ANTI CARDIOLIPIN ANTIBODIES IGA SVC005131 740 1100 1100 1100 1100 1100ANTI -CARDIOLIPIN ANTIBODY (ANTI-PHOSPHOLIPID) IGG SVC003477 820 1230 1230 1230 1230 1230ANTI -CARDIOLIPIN ANTIBODY (ANTI-PHOSPHOLIPID) IGM SVC003478 840 1260 1260 1260 1260 1260ANTI CCP ANTIBODY SVC003933 2030 3050 3050 3050 3050 3050ANTI CENTROMERE ANTIBODIES SVC003934 1420 2130 2130 2130 2130 2130ANTI CYCLIC CITRULLINATED PEPTIDE;ANTI CCP SVC003479 2030 3050 3050 3050 3050 3050ANTI DNASE B, SERUM; ANTIDEOXYRIBONUCLEASE B SVC003480 1260 1890 1890 1890 1890 1890ANTI DS DNA SVC003481 1320 1980 1980 1980 1980 1980ANTI DS DNA, IFA SVC005017 3760 5640 5640 5640 5640 5640ANTI HAV IGG SVC005118 1390 2090 2090 2090 2090 2090ANTI -HBC IGM ANTIBODY SVC003483 1100 1650 1650 1650 1650 1650ANTI HBC TOTAL SVC003484 1270 1910 1910 1910 1910 1910ANTI HEPATITIS DELTA VIRUS ANTIBODY IGM SVC004986 2680 4020 4020 4020 4020 4020ANTI HISTONES ANTIBODIES SVC004904 1420 2130 2130 2130 2130 2130ANTI -LKM-1(LIVER KIDNEY MICROSOMAL ANTIBODIES ) SVC003488 3100 4650 4650 4650 4650 4650ANTI MITOCHONDRIAL ANTIBODY SVC003489 1960 2940 2940 2940 2940 2940Anti MOG (Myelin Oligodendrocyte Glycoprotein) SVC011853 6500 6500 6500 6500 6500 6500ANTI MULLERIAN HORMONE SVC003490 2140 3210 3210 3210 3210 3210ANTI NMO (NEUROMYE LITIS OPTICA) SVC005298 6500 6500 6500 6500 6500 6500ANTI NUCLEAR ANTIBODY (ANA) (ELISA) SVC003936 700 1050 1050 1050 1050 1050ANTI NUCLEAR ANTIBODY / FACTOR (ANA / ANF), IFA (HEP-2) IN DILUTIONS SVC003491 2310 3470 3470 3470 3470 3470ANTI NUCLEAR ANTIBODY / FACTOR (ANA/ANF), EIA SVC003492 740 1110 1110 1110 1110 1110ANTI PARIETAL ANTIBODY SVC003938 1630 2440 2440 2440 2440 2440ANTI RNP SM IGG SVC003941 1680 2520 2520 2520 2520 2520ANTI SM IGG SVC004586 1020 1530 1530 1530 1530 1530ANTI SOLUBLE LIVER ANTIGEN SVC004582 1370 2050 2050 2050 2050 2050ANTI THYROGLOBULIN ANTIBODY(ANTI TG) SVC003943 1300 1950 1950 1950 1950 1950ANTI THYROID ANTIBODIES - THYROGLOBLIN (TGAB) SVC004587 1260 1890 1890 1890 1890 1890ANTI XA ACTIVITY SVC003944 3100 4650 4650 4650 4650 4650ANTI-HAV IGM SVC003494 1380 2070 2070 2070 2070 2070

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteANTITHROMBIN III (AT3) SVC003942 14500 21750 21750 21750 21750 21750ANTITHYROID PEROXIDASE ANTIBODY SVC004318 1370 2050 2050 2050 2050 2050ANTI-TPO (THYROPEROXIDASE) ANTIBODY SVC004278 1500 2250 2250 2250 2250 2250ANTI-U1 RNP ANTIBODIES SVC005119 1790 2680 2680 2680 2680 2680APCR (ACTIVATED PROTEIN C RESISTANT) SVC003947 4100 6140 6140 6140 6140 6140APOLIPOPROTEIN B SVC003497 710 1070 1070 1070 1070 1070APOLIPOPROTIENS SVC003496 1020 1530 1530 1530 1530 1530ARSENIC, BLOOD SVC005207 2890 4330 4330 4330 4330 4330ARTHRITIS PROFILE 1 SVC011260 2420 3620 3620 3620 3620 3620ARTHRITIS PROFILE 2 : (WITHOUT ANTI CCP) SVC011261 3260 4880 4880 4880 4880 4880ASCA IGA (ANTI SACCHOROMYCES CEREVISIAE ANTIBODIES) SVC003949 1540 2320 2320 2320 2320 2320ASCA IGG (ANTI SACCHOROMYCES CEREVISIAE ANTIBODIES) SVC003950 1470 2210 2210 2210 2210 2210ASMA (ANTI-SMOOTH MUSCLE ANTIBODIES) SVC003501 1960 2940 2940 2940 2940 2940ASPERGILLUS ANTIBODIES (IGM & IGG) SVC003951 3200 4800 4800 4800 4800 4800ASPERGILLUS ANTIBODIES IGE SVC005082 1160 1730 1730 1730 1730 1730ASPERGILLUS ANTIBODIES IGG SVC003952 1790 2680 2680 2680 2680 2680AUTO IMMUNE ENCEPHALITIS PANEL SVC005437 6720 10080 10080 10080 10080 10080AUTOIMMUNE ENCEPHATTIS PANEL SVC005443 18900 28350 28350 28350 28350 28350BACTERIAL PNEUMONIA PANEL,PCR SVC005883 7460 11180 11180 11180 11180 11180BAL FLUID (BRONCHO ALVEOLAR LAVAGE) FOR AFB C/S SVC003506 1800 2700 2700 2700 2700 2700BAL FOR PCP 150 SVC003956 2400 3600 3600 3600 3600 3600BARBITURATES SCREENING - URINE SVC005133 1160 1160 1160 1160 1160 1160BENZODIAZEPINES SCREEN - URINE SVC003957 740 1100 1100 1100 1100 1100BETA 2 GLYCOPROTEIN - 1, PANEL SVC005245 2000 2990 2990 2990 2990 2990BETA 2 GLYCOPROTEIN 1 PANNEL IGG, IGM,IGA SVC005299 2730 4100 4100 4100 4100 4100BETA 2 GLYCOPROTEIN IGG SVC005168 970 1450 1450 1450 1450 1450BETA 2 GLYCOPROTEIN IGM SVC005167 970 1450 1450 1450 1450 1450BETA 2 MICROGLOBULIN SVC003959 1300 1950 1950 1950 1950 1950BETA HUMAN CHORIONIC GONADOTROPIN (BETA HCG) SVC003515 760 1140 1140 1140 1140 1140BIOFIRE ME(MENINGOENCEPHALITIS) ADVANTAGE SVC011885 20800 20800 20800 20800 20800 20800BK VIRUS QUANTITATIVE REAL TIME PCR SVC005086 5300 5300 5300 5300 5300 5300BK VIRUS, PCR QUALITATIVE SVC005142 4100 6140 6140 6140 6140 6140

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteBLOCK FOR SPECIAL STAIN SVC003962 230 350 350 350 350 350BLOOD FOR 5 ALPHADIHYDRO TESTOSTERONE (DHT) SVC004573 3200 4800 4800 4800 4800 4800BLOOD FOR ALCOHOL LEVEL SVC004579 740 1110 1110 1110 1110 1110BLOOD FOR ALDEHYDE LEVEL SVC004580 240 360 360 360 360 360BLOOD FOR ANAEROBIC CULTURE/SENSITIVITY SVC003523 1320 1980 1980 1980 1980 1980BLOOD LEAD LEVEL SVC004209 1730 2600 2600 2600 2600 2600BONE MARROW ASPIRATION REPORTING SVC003886 560 830 830 830 830 830BONE MARROW BIOPSY REPORTING SVC003526 880 1320 1320 1320 1320 1320BONE MARROW CYTOGENETICS KARYOTYPING SVC004729 3360 5040 5040 5040 5040 5040BONE SPECIMEN SVC003969 1260 1890 1890 1890 1890 1890BRAF MUTATION ANALYSIS (IHC) SVC006064 5700 5700 5700 5700 5700 5700BRAF MUTATION ANALYSIS (PCR) SVC006092 5700 5700 5700 5700 5700 5700BRAIN NATRIURETIC PEPTIDE (BNP) SVC003966 1790 2680 2680 2680 2680 2680BRCA1 & BRCA 2 MUTATION SVC005194 23100 23100 23100 23100 23100 23100BRCA1 & BRCA2 MUTATION DRUG PROFILING PANEL SVC012963 25000 25000 25000 25000 25000 25000BREAST PANEL (ER, PR, HER II NEU) SVC003971 3800 5700 5700 5700 5700 5700BRUCELLA AGGLUTINATION TEST SVC003972 700 1050 1050 1050 1050 1050BRUCELLA ANTIBODIES (IGM & IGG) SVC003973 1850 2780 2780 2780 2780 2780BRUCELLA ANTIBODIES IGM SVC005072 1210 1810 1810 1810 1810 1810C PEPTIDE SVC003974 1160 1740 1740 1740 1740 1740C1 ESTERASE INHIBITOR PROTEIN QUANTITATION SVC003975 2310 3470 3470 3470 3470 3470CA - 125 SVC003530 1390 2090 2090 2090 2090 2090CA - 15 - 3 SVC003531 1350 2030 2030 2030 2030 2030CA - 19 - 9 SVC003532 1560 2340 2340 2340 2340 2340CALCITONIN SVC003976 2260 3390 3390 3390 3390 3390CALPROTECTIN IN STOOL SVC005149 3680 5520 5520 5520 5520 5520CANCER GENE ANY 3 MARKER (NGS) SVC005563 13500 13500 13500 13500 13500 13500CARBAMAZEPINE SVC003537 800 1200 1200 1200 1200 1200CARCINO EMBRYONIC ANTIGEN (CEA) SVC003540 780 1170 1170 1170 1170 1170CARDIOLIPIN ANTIBODIES PANEL (IGG, IGM & IGA) SVC004966 2520 3780 3780 3780 3780 3780CD 19 SVC004995 2150 3230 3230 3230 3230 3230CD 34 SVC003977 2420 3620 3620 3620 3620 3620

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteCD3 SVC003982 2150 3230 3230 3230 3230 3230CD4/CD8 SVC003983 2510 3760 3760 3760 3760 3760CELL BLOCK STUDY SVC005406 830 1250 1250 1250 1250 1250CERULOPLASMIN SVC003542 1270 1910 1910 1910 1910 1910CHIKUNGUNYA PCR SVC005307 1050 1580 1580 1580 1580 1580CHIKUNGUNYA VIRUS ANTIBODY - IGM SVC004322 630 950 950 950 950 950CHIMERISM (BMT FOLLOW UP) SVC004733 5990 8980 8980 8980 8980 8980CHIMERISM (POST BMT) SVC004732 5990 8980 8980 8980 8980 8980CHIMERISM (PRE BMT) SVC004731 5990 8980 8980 8980 8980 8980CHIMERISM SPLIT CELL ANALYSIS SVC005367 7980 11970 11970 11970 11970 11970CHLAMYDIA ANTIGEN DETECTION SVC003987 2100 3150 3150 3150 3150 3150CHLAMYDIA TRACHOMATIS ANTIBODIES IGG SVC003992 5930 8900 8900 8900 8900 8900CHLAMYDIA TRACOMATIS AND NEISSERIA GONORRHOEAE, PCR QUALITATIVE SVC005293 5040 7560 7560 7560 7560 7560CHROMIUM (BLOOD TEST) SVC005345 3360 5040 5040 5040 5040 5040CHROMOGRANIN A SVC003994 7590 11390 11390 11390 11390 11390CHROMOSOME (KARYOTYPE) ANALYSIS, BLOOD SVC003547 2990 4490 4490 4490 4490 4490CHROMOSOME MICRO ARRAY SVC004893 44100 66150 66150 66150 66150 66150

CHRONIC LYMPHOCYTIC LEUKEMA ONCOINSIGHTS COMBI-PANEL CLL SVC006032 34000 34000 34000 34000 34000 34000CLINICAL EXOME TEST SVC005354 22050 33080 33080 33080 33080 33080

CLL PANEL - FISH (P53/ATM AND D13S319/13QTER/12CEN/MYB6Q23) SVC005140 9500 14250 14250 14250 14250 14250CLOSTRIDIUM DIFFICILE TOXIN A & B SVC003996 2840 4260 4260 4260 4260 4260CMV IGG ANTIBODY (CYTOMEGALOVIRUS) SVC003549 1000 1500 1500 1500 1500 1500CMV IGM & IGG ANTIBODIES SVC003999 1160 1740 1740 1740 1740 1740CMV IGM ANTIBODY (CYTOMEGALOVIRUS) SVC004000 580 870 870 870 870 870CMV QUANTITATIVE VIRAL LOAD PCR SVC005458 8600 12900 12900 12900 12900 12900COCAINE & METABOLITE SCREEN,URINE SVC005860 2520 3780 3780 3780 3780 3780COMPLEMENT C3 SVC003550 760 1140 1140 1140 1140 1140COMPLEMENT C4 SVC003551 760 1140 1140 1140 1140 1140COMPLETE HAEMOGRAM (CGHS) SVC011250 140 210 210 210 210 210

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteCOMPREHENSIVE ALLERGY PROFILE SVC004447 13650 20480 20480 20480 20480 20480COMPREHENSIVE CHRONIC LYMHOCYTIC LEUKEMIA (CLL) PANEL FOR MINIMAL RESIDUAL DISEASE (MRD) SVC004458 11760 17640 17640 17640 17640 17640CORTISOL FREE SERUM SVC005323 7720 11580 11580 11580 11580 11580CORTISOL STIMULATION BY ACTH SVC011852 1730 2600 2600 2600 2600 2600COVID 19 VIRUS QUALITATIVE PCR SVC012365 1250 1250 1250 1250 1250 1250COXSACKIE VIRUS ANTIBODY (IGM & IGG) SVC004002 3260 4880 4880 4880 4880 4880CRP (C -REACTIVE PROTEIN) HS SVC004466 920 1380 1380 1380 1380 1380CRYOGLOBULINS - QUALITATIVE SVC004004 1000 1500 1500 1500 1500 1500CRYPTOCOCCUS ANTIGEN SVC004005 2100 3150 3150 3150 3150 3150CSF - OLIGOCLONAL BAND SVC004006 4730 7100 7100 7100 7100 7100

CSF & SERUM PROTEIN ELECTROPHORESIS / OLIGOCLONAL BANDS SVC004007 4410 6620 6620 6620 6620 6620CYCLOSPORINE LEVEL SVC003572 2640 3960 3960 3960 3960 3960CYSTATIN C SVC004019 1470 2210 2210 2210 2210 2210CYSTICERCUS ANTIBODIES IGG SVC004021 1300 1950 1950 1950 1950 1950CYTOGENETICS (KARYOTYPING) + FISH SVC004024 3200 4800 4800 4800 4800 4800DENGUE IGG ANTIBODIES SVC004026 600 600 600 600 600 600DENGUE IGM ANTIBODIES SVC004028 600 600 600 600 600 600DENGUE NS1 ANTIGEN (ELISA) SVC004878 600 600 600 600 600 600DENGUE NS1 ANTIGEN-RAPID SVC005855 600 600 600 600 600 600DHEA DEHYDROEPIANDR OSTERONE SVC005636 4050 4050 4050 4050 4050 4050DHEA SULPHATE (DHEAS) SVC003581 1160 1740 1740 1740 1740 1740DIGOXIN SVC003586 900 1350 1350 1350 1350 1350DIPHTHERIA IGG ANTIBODY SVC004955 1680 2520 2520 2520 2520 2520DNA - BETA - THALASSEMIA [5 COMMON MUTATION] + HBE SVC004031 19430 29140 29140 29140 29140 29140DONAR SPECIFIC ANTIBODY (DSA) SVC005080 5250 7880 7880 7880 7880 7880DPD GENE MUTATION SVC005352 16800 25200 25200 25200 25200 25200DUCHENNE MUSCULAR DYSTROPHY (DMD ) DELETION/DUPLICATION ANALYSIS BY MLPA ( 79 EXONS ) SVC004501 13000 13000 13000 13000 13000 13000EBV (NA) IGG ANTIBODY SVC004041 2050 3080 3080 3080 3080 3080EBV (NA) IGM ANTIBODY SVC004042 2200 3300 3300 3300 3300 3300

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteEBV (VCA) IGG ANTIBODY SVC004043 1760 2640 2640 2640 2640 2640EBV (VCA) IGM ANTIBODY SVC004044 1850 2780 2780 2780 2780 2780ECHINOCCOCUS (HYDATID CYST) DETECTION FLUID SVC005318 500 750 750 750 750 750ECHINOCOCCUS (HYDATID SEROLOGY)IGG, SERUM SVC003590 1260 1890 1890 1890 1890 1890ELECTRON MICROSCOPY(TEM) SVC005683 7350 11030 11030 11030 11030 11030ENDOMYSIAL IGA ANTIBODY SVC004045 1790 2680 2680 2680 2680 2680ENDOTOXIN FOR DIALYSIS RO WATER SVC004989 1790 2680 2680 2680 2680 2680ENDOTOXIN LEVEL SVC004782 6880 10320 10320 10320 10320 10320ENDOTOXIN TESTING(QUALITATIVE) SVC005135 3620 5430 5430 5430 5430 5430ENZYME ASSAY & GLUCOSIDASE (GAUCHER'S DISEASE) SVC005385 3310 4960 4960 4960 4960 4960ENZYME ASSAY FOR ARYL SULPHATASE A (METACHROMATIC LEUKODYSTROPHY) SVC004556 3360 5040 5040 5040 5040 5040EPIDERMAL GROWTH FACTOR RECEPTOR MUTATION ANAYLSIS SVC004456 2000 2990 2990 2990 2990 2990ER,PR & HER2 NEU SVC005400 3580 5370 5370 5370 5370 5370ERYTHROPOIETIN SVC004046 2210 3320 3320 3320 3320 3320ESTRADIOL II (E2) SVC003596 680 1020 1020 1020 1020 1020ESTROGEN LEVEL (TOTAL) SVC004630 7300 10950 10950 10950 10950 10950ESTROGEN RECEPTOR LEVEL SVC004629 1370 2050 2050 2050 2050 2050ETHYL ALCOHOL-BLOOD LEVEL SVC005441 630 950 950 950 950 950

EXTRACTABLE NUCLEAR ANTIGENS QUALITATIVE PROFILE (ENA) SVC005111 4940 7400 7400 7400 7400 7400

EXTRACTABLENUCLEAR ANTIGENS (ENA), QUANTITATIVE PROFILE SVC005338 7000 7000 7000 7000 7000 7000FACTOR IX ASSAY SVC003604 1750 2630 2630 2630 2630 2630FACTOR V ASSAY SVC003605 3360 5040 5040 5040 5040 5040FACTOR V LEIDEN MUTATION ANALYSIS SVC004050 5500 8250 8250 8250 8250 8250FACTOR VII ASSAY SVC003606 3940 5910 5910 5910 5910 5910FACTOR VIII ASSAY SVC003607 1980 2970 2970 2970 2970 2970FACTOR X ASSAY SVC005222 2150 3230 3230 3230 3230 3230FACTOR XIII SVC003609 480 720 720 720 720 720FANCONI'S ANEMIA, STRESS CYTOGENETICS SVC005347 7770 11660 11660 11660 11660 11660FETAL AUTOPSY SVC004051 2100 3150 3150 3150 3150 3150

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteFIBRINOGEN ASSAY SVC003611 1100 1650 1650 1650 1650 1650FIBROMYALGIA PANEL SVC011287 5880 8820 8820 8820 8820 8820FILARIA ANTIGEN (BLOOD) SVC004052 790 1190 1190 1190 1190 1190FISH - [ALL PANEL] BCR/ABL, TEL /AML1 & MLL SVC005281 8090 12130 12130 12130 12130 12130FISH - FLUORSCENCE IN SITU HYBRIDIZATION SVC004053 8510 12760 12760 12760 12760 12760FISH - MET (7q31) AMPLIFICATION SVC013913 6500 6500 6500 6500 6500 6500FISH APL OR FISH FOR APML SVC012710 5000 5000 5000 5000 5000 5000FISH COMBIPANEL NSCLC SVC012789 15500 15500 15500 15500 15500 15500FISH FOR ALVEOLAR RHABDOMYOSARCOMA(ARMS) SVC012799 10000 10000 10000 10000 10000 10000FISH FOR BURKITT LYMPHOMA (BMA/PB) SVC012723 5000 5000 5000 5000 5000 5000FISH FOR BURKITT LYMPHOMA(FFPE BLOCK) SVC012722 7000 7000 7000 7000 7000 7000FISH FOR CML CHRONIC PHASE CP SVC012749 5000 5000 5000 5000 5000 5000

FISH FOR DIFFUSED LARGE B-CELL LYMPHOMA(DLBCL)(BMA/PB) SVC012725 9000 9000 9000 9000 9000 9000

FISH FOR DIFFUSED LARGE B-CELL LYMPHOMA(DLBCL)(FFPE BLOCK) SVC012724 13000 13000 13000 13000 13000 13000FISH FOR DUAL HIT LYMPHOMA(HIGH GRADE B-CELL LYMPHOMA)(BMA/PB) SVC012727 9000 9000 9000 9000 9000 9000FISH FOR DUAL HIT LYMPHOMA(HIGH GRADE B-CELL LYMPHOMA)(FFPE BLOCK) SVC012726 13000 13000 13000 13000 13000 13000FISH FOR ERBB2(HER2/NEU) BREAST CANCER SVC012781 8000 8000 8000 8000 8000 8000FISH FOR EWING SARCOMA SVC012800 10000 10000 10000 10000 10000 10000FISH FOR EWING SARCOMA EWSR-FLI1 SVC012801 10000 10000 10000 10000 10000 10000FISH FOR FOLLICULAR LYMPHOMA (FL)(FFPE BLOCK) SVC012720 7000 7000 7000 7000 7000 7000FISH FOR FOLLICULAR LYMPHOMA(FL)(BMA/PB) SVC012721 5000 5000 5000 5000 5000 5000FISH FOR HER-2/NEU SVC004646 16280 24410 24410 24410 24410 24410FISH FOR IGH TRANSLOCATION (BMA/PB) SVC012717 5000 5000 5000 5000 5000 5000FISH FOR IGH TRANSLOCATION(FFPE BLOCK) SVC012716 7000 7000 7000 7000 7000 7000FISH FOR INFANTILE FIBROSARCOMA SVC012803 14000 14000 14000 14000 14000 14000FISH FOR LYMPHOMA B-CELL (FFPE BLOCK) SVC012732 15000 15000 15000 15000 15000 15000FISH FOR LYMPHOMA B-CELL(BMA/PB) SVC012733 10000 10000 10000 10000 10000 10000FISH FOR LYMPHOMA T-CELL (BMA/PB) SVC012735 9000 9000 9000 9000 9000 9000

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteFISH FOR LYMPHOMA T-CELL(FFPE BLOCK) SVC012734 13000 13000 13000 13000 13000 13000FISH FOR MALT LYMPHOMA (BMA/PB) SVC012731 9000 9000 9000 9000 9000 9000FISH FOR MALT LYMPHOMA(FFPE BLOCK) SVC012730 13000 13000 13000 13000 13000 13000FISH FOR MANTLE CELL LYMPHOMA (MCL) (BMA/PB) SVC012719 5000 5000 5000 5000 5000 5000FISH FOR MANTLE CELL LYMPHOMA (MCL) (FFPE BLOCK) SVC012718 7000 7000 7000 7000 7000 7000FISH FOR MULTIPLE MYELOMA INCLUDING DEL 17P SVC004330 13440 20160 20160 20160 20160 20160FISH FOR MYXOID LIPOSARCOMA SVC012804 10000 10000 10000 10000 10000 10000FISH FOR ONCOLOGY 1P AND 19Q CODELETION SVC005250 9920 14880 14880 14880 14880 14880FISH FOR SYNOVIAL SARCOMA SVC012805 10000 10000 10000 10000 10000 10000FISH FR EXTRASKELETAL MYXOID CHONDROSARCOMA SVC012802 10000 10000 10000 10000 10000 10000FISH NTRK3 & ETV6 TRANSLOCATION ONCOINSIGHTSTM BREAST CANCER SVC006155 13650 13650 13650 13650 13650 13650FISH XX/XY IN OPPOSITE SEX BMT SVC005141 6690 6690 6690 6690 6690 6690FISH-BCR/ABL OR PHILADELPHIA TRANSLOCATION SVC005662 4520 6770 6770 6770 6770 6770FLOWCYTOMETRIC CD 19/20 COUNT SVC005232 2420 3620 3620 3620 3620 3620FLOWCYTOMETRIC PNH PANEL WITH FLAER SVC005231 6620 9920 9920 9920 9920 9920FLT3 MUTATION SVC004054 3360 5040 5040 5040 5040 5040FOLIC ACID LEVEL SVC003616 2430 3650 3650 3650 3650 3650FRAGILE X ALLELE SIZING BY TP PCR SVC005305 6250 9370 9370 9370 9370 9370FREE BETA HUMAN CHORIONIC GONADOTROPIN (HCG) SVC004325 720 1090 1090 1090 1090 1090FREE PSA SVC004058 890 1340 1340 1340 1340 1340FREE TESTOSTERONE SVC003617 2140 3210 3210 3210 3210 3210FRUCTOSAMINE SVC005233 490 740 740 740 740 740FSH (FOLLICLE STIMULATING HORMONE) SVC003618 620 930 930 930 930 930FUNGAL IDENTIFICATION & SENSITIVITY SVC004953 800 1200 1200 1200 1200 1200G - 6 - PD, NEWBORN SCREEN SVC004061 260 390 390 390 390 390G6 PD SVC003622 920 1380 1380 1380 1380 1380GAD - 65 ANTIBODIES (GLUTAMIC ACID DECARBOXYLASE) SVC004062 6510 9770 9770 9770 9770 9770GALACTOMANNAN SVC005193 5630 8440 8440 8440 8440 8440GALACTOSEMIA (EPIMERASE), QUANTITATIVE, BLOOD SVC004063 2570 3860 3860 3860 3860 3860GANGLIOSIDE ANTIBODY PROFILE IGM SVC005210 4410 6620 6620 6620 6620 6620GENE EXPERT CARBA SVC006117 8000 8000 8000 8000 8000 8000

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteGENE XPERT (XPERTMTB/RIF) SVC004777 2520 3780 3780 3780 3780 3780GLOMERULAR BASEMENT MEMBRANE (GBM) ANTIBODY, IFA SVC003627 1520 2280 2280 2280 2280 2280GLUTAMIC ACID DECARBOXYLASE - 65 IGG SVC004071 6510 9770 9770 9770 9770 9770GROWTH HORMONE SVC004074 790 1190 1190 1190 1190 1190GROWTH HORMONE STIMULATION TEST SVC004075 3310 4960 4960 4960 4960 4960GROWTH HORMONE SUPPRESSION BY GLUCOSE SVC005685 2250 3380 3380 3380 3380 3380H1N1 SVC004076 4500 4500 4500 4500 4500 4500HAINS TEST SVC005199 1800 2700 2700 2700 2700 2700HAMS TEST SVC004077 1260 1890 1890 1890 1890 1890HAPTOGLOBLIN SVC003636 2000 2990 2990 2990 2990 2990HB ELECTROPHORESIS SVC003637 1100 1650 1650 1650 1650 1650HBE AG SVC003639 900 1350 1350 1350 1350 1350HBSAG (HEPATITS B SURFACE ANTIGEN) - ELISA SVC004079 1540 2310 2310 2310 2310 2310HCV GENOTYPING SVC004084 4730 7100 7100 7100 7100 7100HELICOBACTER PYLORI - IGA & IGG SVC004086 3260 4880 4880 4880 4880 4880HELICOBACTER PYLORI ANTIBODIES IGA SVC004088 2730 4100 4100 4100 4100 4100HELICOBACTER PYLORI ANTIGEN IN STOOL SVC005151 2210 3310 3310 3310 3310 3310HEMOGLOBIN HPLC SVC004089 1100 1650 1650 1650 1650 1650HEPATITIS B DNA SVC004644 7670 11500 11500 11500 11500 11500HEPATITIS B E ANTIBODY (ANTI HBE) SVC003643 800 1200 1200 1200 1200 1200HEPATITIS B PROFILE SVC011249 4410 6620 6620 6620 6620 6620HEPATITIS C VIRAL RNA GENOTYPE (LIPA) SVC004645 7040 10550 10550 10550 10550 10550

HEPATITIS C VIRUS RNA (HCV RNA) QUALITATIVE, REAL TIME PCR SVC003645 5940 8910 8910 8910 8910 8910HEPATITIS E (HEV), IGM SVC003646 1850 2780 2780 2780 2780 2780HEPATITIS E PCR QUALITATIVE SVC005124 2680 4020 4020 4020 4020 4020HEPATITIS E VIRUS IGG SVC004093 1580 2370 2370 2370 2370 2370HEPATITIS E VIRUS IGM SVC004094 1600 2400 2400 2400 2400 2400HER2 / FISH SVC004096 11000 16500 16500 16500 16500 16500HERPES SIMPLEX VIRUS (HSV) 1 IGM,SERUM SVC005914 740 1100 1100 1100 1100 1100HERPES SIMPLEX VIRUS (HSV) TYPE 1 & 2, PCR, QUALITATIVE SVC004476 6410 9610 9610 9610 9610 9610HERPES SIMPLEX VIRUS (HSV) TYPE 1, PCR, QUALITATIVE SVC004194 3890 5830 5830 5830 5830 5830

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteHERPES SIMPLEX VIRUS (HSV) TYPE 2, PCR, QUALITATIVE SVC004475 3890 5830 5830 5830 5830 5830HISTOPATHOLOGY, KIDNEY BIOPSY PANEL 1 (HISTOPATHOLOGY ,SPECIAL STAINS ,DIF FOR IGG,IGA, IGM, C3 & C1Q ,MICROPHOTOGRAPHY) SVC003647 3600 5400 5400 5400 5400 5400HISTOPATHOLOGY,KIDNEY BIOPSY PANEL 2 SVC005681 1790 2680 2680 2680 2680 2680HISTOPATHOLOGY,KIDNEY BIOPSY PANEL 3 SVC005682 9000 13500 13500 13500 13500 13500HIV - ELISA SVC004098 510 770 770 770 770 770HIV 1 RNA QUANTITATIVE, REAL TIME PCR WITH CD3,CD4/CD8 MARKERS SVC005436 7720 11580 11580 11580 11580 11580HIV VIRAL LOAD SVC004101 5250 7880 7880 7880 7880 7880HLA - AB (CLASS 1) TYPING SVC005357 7770 11660 11660 11660 11660 11660HLA - B5 SVC004103 4520 6770 6770 6770 6770 6770HLA - DR (CLASS 2) TYPING SVC005358 7770 11660 11660 11660 11660 11660HLA- ABDR MOLECULAR TYPING SVC005448 10080 15120 15120 15120 15120 15120HLA B27 SVC003649 2590 3890 3890 3890 3890 3890HLA B27 (PCR METHOD) SVC005259 3350 5030 5030 5030 5030 5030HLA DNA TYPING FOR KIDNEY / LIVER TRANSPLANT, PCR SVC006053 14800 22200 22200 22200 22200 22200HLA DS (DONOR SPECIFIC IGG AB) SVC005434 10500 15750 15750 15750 15750 15750HLA SINGLE ANTIGEN BEAD ASSAY FOR CLASS 1 & 2 IGG ANTIBODIES DSA SAB CLASS 1 & 2 SVC005916 42000 63000 63000 63000 63000 63000HLA SINGLE ANTIGEN BEAD CLASS II SVC005481 21000 31500 31500 31500 31500 31500HLA T & B CELL FLOW CYTOMETRY, CROSSMATCH SVC005917 3940 5910 5910 5910 5910 5910HLA T & B CELL LYMPHOCYTE CROSS MATCH SVC005356 1840 2760 2760 2760 2760 2760HOMAIR INSULIN RESISTANCE INDEX,CPEPTIDE MODEL SVC005913 2070 2070 2070 2070 2070 2070HOMOCYSTEINE SVC003650 1040 1560 1560 1560 1560 1560HOMOVANILLIC ACID (HVA), 24 - HOUR URINE SVC004105 8400 12600 12600 12600 12600 12600HPV, CHLAMYDIA TRACHOMATIS & NEISSERIA GONORRHEA PCR PANEL, QUALITATIVE SVC011877 4800 4800 4800 4800 4800 4800HSV 1 & 2 IGG ANTIBODIES SVC004110 1200 1800 1800 1800 1800 1800HSV 1 & 2 IGM ANTIBODIES SVC004111 1420 2130 2130 2130 2130 2130HSV 1 & 2, IGG & IGM SVC004896 2480 2480 2480 2480 2480 2480HSV 2 IGG ANTIBODIES SVC004649 740 1100 1100 1100 1100 1100

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteHSV 2 IGM ANTIBODIES SVC004650 740 1100 1100 1100 1100 1100HUMAN EPIDIDYMIS PROTEIN 4 (HE4)-SERUM SVC005161 2210 3320 3320 3320 3320 3320HYDATID ANTIBODIES SVC004113 1420 2130 2130 2130 2130 2130IGF BINDING PROTEIN - 3 SVC004118 4250 6380 6380 6380 6380 6380IGF1 (INSULIN GROWTH FACTOR - 1) SVC004119 4500 6750 6750 6750 6750 6750IGG COVID Antibody SVC012638 250 250 250 250 250 250IHC - 5 MARKERS SVC004720 3780 5670 5670 5670 5670 5670IHC - 6 TO 10 MARKERS SVC004719 8820 13230 13230 13230 13230 13230IHC - MORE THAN 10 MARKERS SVC004721 10400 15590 15590 15590 15590 15590IHC 4 MARKERS SVC004465 6090 9140 9140 9140 9140 9140IHC -ALK-1 SVC005629 3500 4200 4200 4200 4200 4200IHC FOR DESMIN SVC005442 1630 2440 2440 2440 2440 2440IHC MARKER SVC005431 6040 9060 9060 9060 9060 9060IHC -PDL-1 SVC005628 3500 4200 4200 4200 4200 4200IHC SINGLE MARKER SVC004464 2200 3300 3300 3300 3300 3300IMATINIB RESISTANCE MUTATION ANALYSIS (IRMA) SVC004120 8190 12290 12290 12290 12290 12290IMD PANEL, QUANTITATIVE, BLOOD (AMINO ACIDS, ORGANIC ACIDS, FATTY ACIDS) SVC003652 4200 6300 6300 6300 6300 6300IMMATURE PLATELET FRACTION (IPF) SVC005343 630 950 950 950 950 950IMMUNE DEFICIENCY PANEL SVC004459 2520 3780 3780 3780 3780 3780IMMUNO DEFICIENCY PANEL FOR CD-4 COUNT SVC004654 1600 2400 2400 2400 2400 2400IMMUNO DEFICIENCY PANEL II (CD3, CD4, DC8) SVC004801 2510 3770 3770 3770 3770 3770IMMUNO DEFICIENCY PANEL III (CD3) SVC004804 2520 3780 3780 3780 3780 3780IMMUNOFIXATION ELECTROPHORESIS (IFE), SERUM SVC004121 7160 10740 10740 10740 10740 10740IMMUNOFIXATION ELECTROPHORESIS, 24 - HOUR URINE SVC004122 8400 12600 12600 12600 12600 12600IMMUNOGLOBULIN (IGG) SYNTHESIS INDEX & RATE SVC005585 2450 2450 2450 2450 2450 2450IMMUNOHISTOCHEMISTRY , CUSTOM PANEL SVC005248 6930 10400 10400 10400 10400 10400IMMUNOHISTOCHEMISTRY CMV SVC011453 1850 1850 1850 1850 1850 1850INHIBIN B SVC005042 2000 2990 2990 2990 2990 2990INSULIN (FASTING) SVC004127 920 1380 1380 1380 1380 1380INSULIN (POST PRANDIAL) SVC004128 920 1380 1380 1380 1380 1380INSULIN ANTIBODIES SVC004473 2100 3150 3150 3150 3150 3150

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteINTERLEUKIN-6(IL-6) SVC003655 3150 3300 3300 3300 3300 3300INTRINSIC FACTOR ANTIBODY SVC004129 2520 3780 3780 3780 3780 3780IONISED CALCIUM SVC003656 670 1010 1010 1010 1010 1010ISLET CELL ANTIBODY SVC004130 1800 2700 2700 2700 2700 2700JAK - 2 SVC004131 6120 9180 9180 9180 9180 9180JAPANESE ENCEPHALITIS VIRUS (JE VIRUS) - CSF SVC004132 7510 11260 11260 11260 11260 11260JAPANESE ENCEPHALITIS VIRUS (JE VIRUS) - SERUM SVC004133 47880 71820 71820 71820 71820 71820KIDNEY BIOPSY - HISTOPATHOLOGY SVC003661 2100 3150 3150 3150 3150 3150KRAS NRAS MUTATION ANALYSIS (IHC) SVC006065 11000 11000 11000 11000 11000 11000KRAS NRAS MUTATION ANALYSIS (PCR) SVC011876 11000 11000 11000 11000 11000 11000LACTATE (LACTIC ACID) SVC003663 970 1460 1460 1460 1460 1460LAP SCORE (LEUCOCYTE ALKALINE PHOSPHATASE SCORE) SVC004135 900 900 900 900 900 900LE CELLS SVC004136 370 550 550 550 550 550LEGIONELLA ANTIGEN,URINE(ICT) SVC005859 720 1090 1090 1090 1090 1090LEGIONELLA PNEUMOMIA ANTIBODIES (IGM & IGG) SVC004138 8900 13360 13360 13360 13360 13360LEGIONELLA PNEUMOPHILA TOTAL ANTIBODY, SERUM SVC011878 6980 6980 6980 6980 6980 6980LEISHMANIA(KALA-AZAR) ANTIBODY (IGG) SVC004662 1680 2520 2520 2520 2520 2520LEISHMANIA(KALA-AZAR) ANTIBODY (RK39) SVC005650 630 950 950 950 950 950LEPTOSPIRA (IGM) ANTIBODY SVC004141 1420 2130 2130 2130 2130 2130LEPTOSPIRA ANTIBODY (IGG AND IGM) (QUANTITATIVE) SVC004664 2500 3750 3750 3750 3750 3750LEPTOSPIRA ANTIBODY (IGG) (QUANTITATIVE) SVC004663 1790 2680 2680 2680 2680 2680LEPTOSPIRA ANTIBODY IGG SVC004451 1420 2130 2130 2130 2130 2130LEPTOSPIRA DETECTION, PCR SVC005241 2630 3940 3940 3940 3940 3940LIPOPROTEIN (A) SVC004448 1020 1530 1530 1530 1530 1530LIVER KIDNEY MICROSOMES LKM -1 SVC003670 1850 2780 2780 2780 2780 2780LN BIOPSY SVC004144 2470 3700 3700 3700 3700 3700LUPUS ANTICOAGULANT SVC004146 1700 2550 2550 2550 2550 2550LUPUS ANTICOAGULANT PANEL; LAC PANEL. SVC011879 2730 2730 2730 2730 2730 2730LUTEINIZING HORMONE (LH) SVC003667 660 990 990 990 990 1020LYME DISEASE (BORRELIA BURGDORFERI IGG) SVC005092 6200 9290 9290 9290 9290 9290LYME DISEASE (BORRELIA BURGDORFERI IGM) SVC005093 3570 5360 5360 5360 5360 5360LYMPHOMA DIAGNOSTIC PANEL (FLOW CYTOMETRY) SVC004806 17120 25670 25670 25670 25670 25670

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteMATERNAL QUAD SCREEN TEST SVC004667 4100 6140 6140 6140 6140 6140MATERNAL SERUM SCREEN 2 (DUAL TEST) SVC004324 2490 3740 3740 3740 3740 3740MATERNAL SERUM SCREEN 3 - TRIPLE TEST (AFP ,BETA HCG ,FREE ESTRIAL ,RISK EVALUATION) SVC003676 2700 4050 4050 4050 4050 4050MEASLES ANTIBODIES (IGM & IGG) SVC004154 3150 4730 4730 4730 4730 4730MEASLES IGG ANTIBODIES SVC004155 1680 2520 2520 2520 2520 2520MEASLES IGM ANTIBODIES SVC003680 1680 2520 2520 2520 2520 2520MENINGITIS SVC004978 12080 18110 18110 18110 18110 18110METAL SCREEN 1Â SERUM SVC012900 6330 6330 6330 6330 6330 6330METAL SCREEN 3, URINE SVC012901 15400 15400 15400 15400 15400 15400METHOTREXATE SVC004985 2700 4050 4050 4050 4050 4050MICRO FILARIA (SMEAR) SVC004159 210 320 320 320 320 320MTFR (METHYLENE TETRAHYDROFOLATE REDUCTASE) GENEMUTATION QULITATIVE PCR SVC005423 3360 5040 5040 5040 5040 5040MTHFR GENE MUTATION SVC004912 3200 3200 3200 3200 3200 3200MULTIPLE MYELOMA SCREENING PANEL SVC005858 8400 12600 12600 12600 12600 12600MUMPS ANTIBODIES (IGM & IGG) SVC004162 2570 3860 3860 3860 3860 3860MUMPS IGG ANTIBODIES SVC004163 1680 2520 2520 2520 2520 2520MUMPS IGM ANTIBODIES SVC004164 1760 2650 2650 2650 2650 2650MUSCLE SPECIFIC RECEPTOR TYROSINE KINASE AB(MUSK AB) SVC004770 5780 8660 8660 8660 8660 8660MYCOPLASMA PNEUMONIAE ANTIBODIES (IGM & IGG) SVC004167 3780 5670 5670 5670 5670 5670MYCOPLASMA PNEUMONIAE ANTIBODY IGM SVC004169 2100 3150 3150 3150 3150 3150MYELODYSPLASTIC SYNDROME FISH PANEL SVC004899 8190 12290 12290 12290 12290 12290

MYELODYSPLASTIC SYNDROME ONCOINSIGHTS COMBI-PANEL MDS SVC006033 26700 26700 26700 26700 26700 26700MYELOPEROXIDASE CYTOCHEMISTRY-BONE MARROW SVC005097 530 790 790 790 790 790NEURON SPECIFIC ENOLASE (NSE) SVC004176 1630 2440 2440 2440 2440 2440NEURONAL(PARANEOPLASTIC)AUTOANTIBODIES PROFILE SVC005882 9000 13500 13500 13500 13500 13500NEUROVIRUSES PANEL, QUALITATIVE PCR SVC005915 6300 9450 9450 9450 9450 9450NEWBORN SCREENING- BASIC SVC011271 1890 2840 2840 2840 2840 2840NEWBORN SCREENING PANEL 5 SVC004177 1470 2210 2210 2210 2210 2210NEWBORN SCREENING-EXTENDED PROFILE SVC011272 5250 7880 7880 7880 7880 7880

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteNMDA RECEPTOR ANTIBODIES SVC004572 6770 10160 10160 10160 10160 10160NMDA RECEPTOR ANTIBODY SVC005139 10320 10320 10320 10320 10320 10320NOTCH3 MUTATION DETECTION; CADASIL SVC012902 11000 11000 11000 11000 11000 11000ONCOINSIGHTSâ„¢ CELL LINE KARYOTYPING SVC012755 20000 20000 20000 20000 20000 20000ONCOINSIGHTSâ„¢ CHROMOSOMAL BREAKAGE STUDIES IN FANCONIâ€™S ANEMIA/APLASTIC ANEMIA SVC012756 11000 11000 11000 11000 11000 11000ONCOINSIGHTSâ„¢ ADVANCED COMBIPANEL - MDS SVC012762 31500 31500 31500 31500 31500 31500ONCOINSIGHTSâ„¢ ADVANCED COMBIPANEL PANEL - AML SVC012699 33500 33500 33500 33500 33500 33500ONCOINSIGHTSâ„¢ CK + FISH B-ALL SVC012697 18000 18000 18000 18000 18000 18000ONCOINSIGHTSâ„¢ CK + FISH B-ALL, IKZF1 MUTATION ANALYSIS REFLEX TO PH1 LIKE ALL. SVC012685 30000 30000 30000 30000 30000 30000ONCOINSIGHTSâ„¢ COMBI PANEL CML CHRONIC PHASE CP SVC012746 16800 16800 16800 16800 16800 16800ONCOINSIGHTSâ„¢ COMBI-PANEL MDS SVC012765 26700 26700 26700 26700 26700 26700ONCOINSIGHTSâ„¢ COMBIPANEL PANEL - AML SVC012701 28000 28000 28000 28000 28000 28000ONCOINSIGHTSâ„¢ CONVENTIONAL KARYOTYPING + NGS AML SVC012700 21000 21000 21000 21000 21000 21000ONCOINSIGHTSâ„¢ CYTOGENETIC PANEL MDS SVC012766 15000 15000 15000 15000 15000 15000

ONCOINSIGHTSâ„¢ CYTOGENETIC PANEL (MM) MULTIPLE MYELOMA SVC012759 24000 24000 24000 24000 24000 24000ONCOINSIGHTSâ„¢ CYTOGENETIC PANEL AML SVC012702 18000 18000 18000 18000 18000 18000ONCOINSIGHTSâ„¢ CYTOGENETIC PANEL B-ALL SVC012687 18000 18000 18000 18000 18000 18000

ONCOINSIGHTSâ„¢ CYTOGENETIC PANEL B-ALL REFLEX TO PH1 LIKE ALL SVC012686 25000 25000 25000 25000 25000 25000ONCOINSIGHTSâ„¢ CYTOGENETIC PANEL CML BLAST PHASE BP SVC012748 15750 15750 15750 15750 15750 15750

ONCOINSIGHTSâ„¢ CYTOGENETIC PANEL CML CHRONIC PHASE CP SVC012747 10500 10500 10500 10500 10500 10500ONCOINSIGHTSâ„¢ CYTOGENETIC PANEL PLOIDY ANALYSIS + B-ALL, IKZF1 MUTATION ANALYSIS REFLEX TO PH1 LIKE ALL. SVC012684 30000 30000 30000 30000 30000 30000ONCOINSIGHTSâ„¢ FISH COMBIPANEL-1 NSCLC SVC012790 25200 25200 25200 25200 25200 25200ONCOINSIGHTSâ„¢ FISH COMBIPANEL-2 NSCLC SVC012791 31500 31500 31500 31500 31500 31500ONCOINSIGHTSâ„¢ FISH PANEL - AML SVC012706 14000 14000 14000 14000 14000 14000ONCOINSIGHTSâ„¢ FISH PANEL B - ALL SVC012688 14000 14000 14000 14000 14000 14000

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ONCOINSIGHTSâ„¢ FISH PANEL B - ALL + IKZF1 MUTATION ANALYSIS SVC012691 20000 20000 20000 20000 20000 20000ONCOINSIGHTSâ„¢ FISH PANEL CEL SVC012739 10000 10000 10000 10000 10000 10000ONCOINSIGHTSâ„¢ FISH PANEL HCL SVC012757 10000 10000 10000 10000 10000 10000ONCOINSIGHTSâ„¢ FISH PANEL HEPATOSPLENIC Î“, Î” T-CELL LYMPHOMA(BMA/PB) SVC012737 7000 7000 7000 7000 7000 7000ONCOINSIGHTSâ„¢ FISH PANEL HEPATOSPLENIC Î“, Î” T-CELL LYMPHOMA(FFPE BLOCK) SVC012736 10000 10000 10000 10000 10000 10000ONCOINSIGHTSâ„¢ FISH PANEL MDS SVC012767 10000 10000 10000 10000 10000 10000ONCOINSIGHTSâ„¢ FISH PANEL MM MULTIPLE MYELOMA SVC012760 18800 18800 18800 18800 18800 18800ONCOINSIGHTSâ„¢ FISH PANEL MPN/MPD SVC012769 11000 11000 11000 11000 11000 11000ONCOINSIGHTSâ„¢ FISH PANEL PH1 LIKE B-ALL SVC012689 10000 10000 10000 10000 10000 10000ONCOINSIGHTSâ„¢ FISH PANEL T - ALL SVC012693 14000 14000 14000 14000 14000 14000ONCOINSIGHTSâ„¢ FISH PANEL T-CELL PROLYMPHOCYTIC LEUKEMIA (T-PLL) SVC012694 10000 10000 10000 10000 10000 10000ONCOINSIGHTSâ„¢ FISHPANEL CML BLAST PHASE BP SVC012750 10000 10000 10000 10000 10000 10000ONCOINSIGHTSâ„¢ JAK2 REFLEX PANEL MPN/MPD SVC012770 7000 7000 7000 7000 7000 7000ONCOINSIGHTSâ„¢ MDS CONVENTIONAL KARYOTYPING + NGS SVC012763 21000 21000 21000 21000 21000 21000ONCOINSIGHTSâ„¢ MDS NGS(MUTATIONS) PANEL SVC012764 15000 15000 15000 15000 15000 15000ONCOINSIGHTSâ„¢ MOLECULAR PANEL MDS SVC012768 18000 18000 18000 18000 18000 18000ONCOINSIGHTSâ„¢ MOLECULAR PANEL MPN/MPD JAK2 V617F, MPL & CALR SVC012771 12000 12000 12000 12000 12000 12000ONCOINSIGHTSâ„¢ MOLECULAR PANEL MPN/MPD JAK2 EXON 12, MPL & CALR SVC012772 12000 12000 12000 12000 12000 12000ONCOINSIGHTSâ„¢ MOLECULAR PANEL MPN/MPD JAK2 REFLEX, MPL & CALR SVC012773 15000 15000 15000 15000 15000 15000ONCOINSIGHTSâ„¢ NGS FOR ALL SVC012814 33000 33000 33000 33000 33000 33000ONCOINSIGHTSâ„¢ NGS PANEL AML(FUSIONS) SVC012705 15000 15000 15000 15000 15000 15000

ONCOINSIGHTSâ„¢ NGS PANEL AML(MUTATIONS & TRANSLOCATIONS) SVC012703 20000 20000 20000 20000 20000 20000ONCOINSIGHTSâ„¢ NGS PANEL AML(MUTATIONS) SVC012704 15000 15000 15000 15000 15000 15000ONCOINSIGHTSâ„¢ NGS PANEL APML(FUSIONS) SVC012715 15000 15000 15000 15000 15000 15000

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteONCOINSIGHTSâ„¢ NGS PANEL CEL(FUSIONS) SVC012740 15000 15000 15000 15000 15000 15000ONCOINSIGHTSâ„¢ PH1 LIKE B-ALL FISH PANEL EXTENDED + IKZF1 MUTATION ANALYSIS SVC012692 20000 20000 20000 20000 20000 20000ONCOINSIGHTSâ„¢ PH1 LIKE B-ALL FISH PANEL EXTENDED: SVC012690 14000 14000 14000 14000 14000 14000ONCOINSIGHTSâ„¢COMBI- PANELCLL SVC012741 34000 34000 34000 34000 34000 34000ONCOINSIGHTSâ„¢CYTOGENETIC PANEL CLL SVC012742 18800 18800 18800 18800 18800 18800ONCOINSIGHTSâ„¢FISH NTRK3 & ETV6 TRANSLOCATION BREAST CANCER SVC012782 13650 13650 13650 13650 13650 13650ONCOINSIGHTSâ„¢FISH PANEL FOR TRIPLE HIT LYMPHOMA(HIGH GRADE B-CELL LYMPHOMA)(BMA/PB) SVC012729 13000 13000 13000 13000 13000 13000ONCOINSIGHTSâ„¢FISH PANEL FOR TRIPLE HIT LYMPHOMA(HIGH GRADE B-CELL LYMPHOMA)(FFPE BLOCK) SVC012728 18000 18000 18000 18000 18000 18000ONCOINSIGHTSâ„¢FISH PANELCLL SVC012743 14000 14000 14000 14000 14000 14000ONCOINSIGHTSâ„¢MOLECULAR PANELCLL SVC012744 16000 16000 16000 16000 16000 16000ONCOINSIGHTSâ„¢MOLECULAR PANELCLL(IGHV&TP53) SVC012745 16000 16000 16000 16000 16000 16000ONCOPRO 350 GENE TMB & MSI PROFILE SVC013734 60000 60000 60000 60000 60000 60000OSMOLAL GAP, SERUM SVC011861 980 980 980 980 980 980OSMOTIC FRAGILITY SVC003890 510 770 770 770 770 770PANCREATIC ELASTASE SVC005183 5000 7500 7500 7500 7500 7500PAPP-A SVC005079 950 1420 1420 1420 1420 1420PARA NEOPLASTIC ANTIBODY PANEL WORKUP SVC004799 6850 6850 6850 6850 6850 6850PARIETAL CELL ANTIBODY ,IFA IN DILUTION SVC005637 3140 4710 4710 4710 4710 4710PARVOVIRUS B 19 ANTIBODIES (IGM & IGG) SVC004182 4780 7170 7170 7170 7170 7170PARVOVIRUS B19 DNA PCR SVC004570 2630 3940 3940 3940 3940 3940PAUL BUNNELL TEST (INFECTIOUS MONONUCLEOSIS) SVC004185 1160 1730 1730 1730 1730 1730PCR FOR CYTOMEGALOVIRUS - QUALITATIVE SVC004186 4310 6460 6460 6460 6460 6460PCR FOR CYTOMEGALOVIRUS - QUANTIFICATION SVC004187 13860 20790 20790 20790 20790 20790PCR FOR EBV - DNA - QUALITATIVE SVC004189 4410 6620 6620 6620 6620 6620PCR FOR EBV - DNA - QUANTITATIVE SVC004188 6000 6000 6000 6000 6000 6000PCR FOR HBV DNA -QUALITATIVE SVC003694 5080 7620 7620 7620 7620 7620PCR FOR HCV RNA - QUALITATIVE SVC004191 4520 6780 6780 6780 6780 6780PCR FOR JC/BK DNA SVC004987 6830 10240 10240 10240 10240 10240

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuitePCR FOR PAN FUNGAL - QUALITATIVE SVC004196 2470 3700 3700 3700 3700 3700PCR FOR TB (AFB) - QUALITATIVE SVC004198 2000 3000 3000 3000 3000 3000PCR FOR TB (AFB) - QUANTITATIVE SVC003884 2840 4260 4260 4260 4260 4260PCR FOR TOXOPLASMA GONDII SVC004199 1840 2760 2760 2760 2760 2760PDGFRA MUTATION ANALYSIS SVC004979 4880 7320 7320 7320 7320 7320PHADIATOP TEST SVC005370 950 1430 1430 1430 1430 1430PHENOBARBITONE SVC003714 920 1380 1380 1380 1380 1380PHENYTOIN SVC003715 1020 1530 1530 1530 1530 1530PHOSPHOLIPASE A2 RECEPTOR ANTIBODY (PLA2R) SVC005412 6510 9770 9770 9770 9770 9770PHOSPHOLIPID ANTIBODIES PANEL (IGG & IGM) SVC005279 1540 2310 2310 2310 2310 2310PLASMA AMINO ACIDO GRAM SVC004207 1050 1580 1580 1580 1580 1580PLASMA FREE METANEPHRINES SVC005269 6000 6000 6000 6000 6000 6000PLASMA RENIN SVC004210 5460 8190 8190 8190 8190 8190PLEURAL FLUID - TBPCR SVC004215 2000 3000 3000 3000 3000 3000PLEURAL FLUID AFB CULTURE FOR (BACTEC METHOD) SVC004216 1730 2600 2600 2600 2600 2600POLARISING MICROSCOPY FOR CRYSTALS INCLUDES CELL COUNT SYNOVIAL FLUID SVC005469 320 470 470 470 470 470PORPHOBILINOGEN (PBG), QUALITATIVE, URINE SVC004217 3680 5520 5520 5520 5520 5520PORPHYRINS TOTAL, QUALITATIVE, RANDOM URINE SVC004219 5670 8510 8510 8510 8510 8510PROGESTERONE SVC003730 640 960 960 960 960 960PROLACTIN SVC003731 610 920 920 920 920 920PROTEIN C SVC004221 3950 5930 5930 5930 5930 5930PROTEIN ELECTROPHORESIS SVC004222 790 1190 1190 1190 1190 1190PROTEIN ELECTROPHORESIS & IFE SVC004223 710 1070 1070 1070 1070 1070

PROTEIN ELECTROPHORESIS, 24 - HOUR URINE DOES NOT INCLUDE IFE. SVC004224 5850 8770 8770 8770 8770 8770

PROTEIN ELECTROPHORESIS, SERUM INCLUDES TOTAL PROTEIN, ELECT SVC003732 4410 6620 6620 6620 6620 6620PROTEIN S SVC004225 3300 4950 4950 4950 4950 4950PROTROMBIN GENE MUTATION SVC004913 3470 5200 5200 5200 5200 5200PUS FOR AEROBIC C/S SVC004226 790 1180 1180 1180 1180 1180

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteQUADRUPLE TEST (MATERNAL SCREEN - AFP, BETA HCG, FREE ESTRIOL, INHIBIN A) SVC004737 3620 5430 5430 5430 5430 5430QUANTIFERON TB GOLD SVC003745 2680 4020 4020 4020 4020 4020RED CELL FOLATE (RBC FOLATE) SVC004233 2210 3310 3310 3310 3310 3310

REGULAR HISTOPATHOLOGY -LARGE COMPLEX CANER RESECTION SVC005630 3500 5250 5250 5250 5250 5250REGULAR HP EXTRA LARGE SPECIMEN SVC004234 3310 4970 4970 4970 4970 4970REGULAR HP LARGE SPECIMEN SVC003753 2630 3950 3950 3950 3950 3950REGULAR HP MEDIUM SPECIMEN SVC004235 2100 3150 3150 3150 3150 3150REGULAR HP SMALL SPECIMEN SVC003754 870 1310 1310 1310 1310 1310RHEUMATOID ARTHRITIS PANEL SVC011286 1680 2520 2520 2520 2520 2520

RICKETTSIA ANTIBODY PANEL (IGG, IGM, QUANTITATIVE BY IFA) SVC005137 16800 25200 25200 25200 25200 25200ROS-1 -IMMUNOHISTOCHEMISTRY SVC005939 4200 6300 6300 6300 6300 6300RT - PCR FOR HIV SVC004236 3680 5510 5510 5510 5510 5510RT PCR FOR BCR - ABL QUALITATIVE SVC004237 3260 4890 4890 4890 4890 4890RT PCR FOR BCR - ABL QUANTITATIVE SVC004238 6300 9450 9450 9450 9450 9450RT PCR QUALYTATIVE FOR PML RARA TRANSLOCATION SVC005311 10320 10320 10320 10320 10320 10320RT PCR QUANTITATIVE FOR PML / RARA TRANSLOCATION SVC004239 5460 8190 8190 8190 8190 8190RT-PCR FOR HIV-1 RNS QUANTITATIVE WITH CD-3, CD-4, CD-8 SVC004651 7700 11550 11550 11550 11550 11550RUBELLA ANTIBODIES (IGM & IGG) SVC004240 1160 1730 1730 1730 1730 1730RUBELLA IGG ANTIBODY SVC003758 660 990 990 990 990 990RUBELLA IGM ANTIBODY SVC004241 600 900 900 900 900 900SCL 70 ANTIBODY (IGG) SVC004689 1050 1580 1580 1580 1580 1580SCREENING OF FRAGILE X SYNDROME(PCR BASED) SVC004511 3100 4650 4650 4650 4650 4650SCRUB TYPHUS IGM (ELISA) SVC005076 1100 1100 1100 1100 1100 1100SCRUB TYPHUS,QUALITATIVE(CARD TEST) SVC004952 840 1260 1260 1260 1260 1260SEPSIS SVC004976 5570 8350 8350 8350 8350 8350SERUM ANTI PARIETAL/ANTI INTRINSIC FACTOR (IF) SVC004245 3260 4880 4880 4880 4880 4880SERUM ASPERGILLUS GALACTOMANNAN AG SVC004246 5630 8440 8440 8440 8440 8440SERUM BICARBONATE LEVEL SVC003881 690 1040 1040 1040 1040 1040SERUM CHOLINESTERASE SVC003765 510 770 770 770 770 770

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteSERUM COPPER SVC004247 1370 2060 2060 2060 2060 2060SERUM COPPER (ATOMIC ABSORPTION) SVC004612 1630 2440 2440 2440 2440 2440SERUM CORTISOL (4PM) SVC003556 580 870 870 870 870 870SERUM CORTISOL (8 AM) SVC003557 640 960 960 960 960 960SERUM CORTISOL RANDOM SVC003767 610 920 920 920 920 920SERUM ETHANOL SVC005218 750 1120 1120 1120 1120 1120SERUM FOR ANDROSTENEDIONE SVC004474 2970 2970 2970 2970 2970 2970SERUM FOR BETA 2 GYLCOPROTEIN SCREEN (IGG, IGM, IGA) SVC004455 2730 4100 4100 4100 4100 4100SERUM FOR CA 72.4 (GASTRIC CANCER MARKER) SVC004599 1520 2280 2280 2280 2280 2280SERUM FOR CD 20 SVC004604 2210 3310 3310 3310 3310 3310SERUM FOR ECHINO COCCAL SVC004627 1630 2440 2440 2440 2440 2440SERUM FOR FOLATE SVC004691 1330 2000 2000 2000 2000 2000SERUM FOR HCG (TOTAL) SVC004643 690 1040 1040 1040 1040 1040SERUM FOR LIPOPROTEIN A SVC004716 970 1460 1460 1460 1460 1460SERUM FOR NMO 4 ANTIBODIES (AQUAPORINE 4 ANTIBODIES) SVC004479 6830 10240 10240 10240 10240 10240SERUM FREE LIGHT CHAIN ASSAY SVC004248 8450 12680 12680 12680 12680 12680SERUM GASTRIN SVC004249 1430 2150 2150 2150 2150 2150SERUM IGA SVC003770 370 560 560 560 560 560SERUM IGE SVC003771 1020 1530 1530 1530 1530 1530SERUM IGG SVC003772 410 620 620 620 620 620SERUM IGG 4 SVC004875 6500 9750 9750 9750 9750 9750SERUM IGM SVC003773 590 890 890 890 890 890SERUM IMMUNOGLOBULIN (IGA IGM IGG ) SVC003774 1040 1560 1560 1560 1560 1560SERUM IMMUNOGLOBULIN D (IGD) SVC005044 7300 10950 10950 10950 10950 10950SERUM LEPTIN SVC004251 4100 6140 6140 6140 6140 6140SERUM LITHIUM SVC003775 340 510 510 510 510 510SERUM MYOGLOBIN SVC004252 4200 6300 6300 6300 6300 6300SERUM OXALATE SVC004253 790 1180 1180 1180 1180 1180SERUM PYRUVATE SVC004254 3410 5120 5120 5120 5120 5120SERUM TOTAL BILE ACID LEVEL SVC005153 1730 2600 2600 2600 2600 2600SERUM VITAMIN E (TOCOPHEROL) SVC004726 6300 9450 9450 9450 9450 9450SERUM ZINC SVC004256 1800 2700 2700 2700 2700 2700

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteSEX HORMONE BINDING GLOBULIN (SHBG) SVC004257 2470 3710 3710 3710 3710 3710SLIDE & BLOCK FOR REVIEW SVC004260 610 920 920 920 920 920SLIDE & BLOCK FOR REVIEW (BONE MARROW) SVC004773 910 1370 1370 1370 1370 1370SLIDE FOR REVIEW SVC004261 740 1100 1100 1100 1100 1100SPINAL CEREBELLAR ATAXIA ( SCA ) - ONE GENE SVC004544 4410 6620 6620 6620 6620 6620SPOT URINE MICROALBUMIN / CREATININE RATIO SVC004926 680 1020 1020 1020 1020 1020SPUTUM FOR .AFB CULTURE - (BACTEC METHOD) SVC004263 1050 1580 1580 1580 1580 1580SPUTUM FOR AFB CULTURE - (LJ METHOD) SVC004264 800 1200 1200 1200 1200 1200SS-A(RO) ANTIBODY SVC004747 1450 2180 2180 2180 2180 2180SS-A/RO ANTIBODY SVC005339 1680 2520 2520 2520 2520 2520SS-B(LA) ANTIBODY SVC004748 1450 2180 2180 2180 2180 2180SS-B/LA ANTIBODY SVC005340 1680 2520 2520 2520 2520 2520Standard QÂ COVID-19 Ag SVC012678 650 650 650 650 650 650STONE FOR ANALYSIS (CALCULUS FOR BIOCHEMICAL EXAM) SVC004267 1050 1580 1580 1580 1580 1580SWINE FLU H1N1 TEST SVC003802 4500 4500 4500 4500 4500 4500SYSTEMIC LUPUS ERYTHEMATOSUS PANEL SVC012679 4360 6540 6540 6540 6540 6540T AND B CELL CROSS MATCH SVC005302 3940 5910 5910 5910 5910 5910TACROLIMUS SVC004273 3780 3780 3780 3780 3780 3780TB PCR (GENEXPERT) SVC005065 2540 3810 3810 3810 3810 3810TESTOSTERONE SVC003812 690 1040 1040 1040 1040 1040THIOPURINE METHYLTRANSFERASE (TPMT) SVC004727 5200 7800 7800 7800 7800 7800THROMBOPHILIA COMPREHENSIVE PROFILE SVC005217 16500 24750 24750 24750 24750 24750THROMBOPHILIA PROFILE SVC005198 15000 22500 22500 22500 22500 22500THROMBOPHILIA WORK UP SVC011247 14070 21110 21110 21110 21110 21110THROMBOTIC RISK SCREEN SVC005918 13650 20480 20480 20480 20480 20480THYROGLOBULIN SVC004274 1790 2680 2680 2680 2680 2680TISSUE FOR ANAEROBIC C/S SVC004275 1100 1650 1650 1650 1650 1650TISSUE TRANSGLUTAMINAS E TTGDGP SCREEN SVC005912 2000 2990 2990 2990 2990 2990TNF, TUMOR NECROSIS FACTOR ALPHA SVC005411 7430 7430 7430 7430 7430 7430TORCH IGG ANTIBODIES SVC011248 3100 4650 4650 4650 4650 4650TORCH IGM ANTIBODIES SVC011236 1960 2940 2940 2940 2940 2940TORCH PANEL (IGG&IGM) SVC003818 2630 3940 3940 3940 3940 3940

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteTOXOPLASMA IGG ANTIBODY SVC003820 610 910 910 910 910 910TOXOPLASMA IGM & IGG ANTIBODIES SVC004276 1050 1580 1580 1580 1580 1580TOXOPLASMA IGM ANTIBODY SVC004277 610 910 910 910 910 910TPHA SVC003821 640 960 960 960 960 960TRACHEAL SECRECTION FOR PCP SVC004279 170 250 250 250 250 250

TRIPLE MARKER (MATERNAL SCREEN -AFP, BETA HCG, FREE ESTRIOL) SVC004280 2700 4050 4050 4050 4050 4050TROPONIN T - CARDIAC MARKER SVC004281 1530 2300 2300 2300 2300 2300TROPONIN-I HS ULTRA SVC005905 1950 2930 2930 2930 2930 2930TRYPTASE SVC005078 7040 10550 10550 10550 10550 10550TSH RECEPTOR ANTIBODY SVC004969 4140 6210 6210 6210 6210 6210TSH, NEWBORN SCREEN SVC004282 260 390 390 390 390 390TTG (TISSUE TRANSGLUTAMINASE ) IGA SVC003828 1160 1740 1740 1740 1740 1740TTG (TISSUE TRANSGLUTAMINASE ) IGG SVC005160 1050 1580 1580 1580 1580 1580TYPHOID ANTIBODY (IGG AND IGM) SVC004704 620 930 930 930 930 930URINE FOR AFB CULTURE - (BACTEC METHOD) SVC004285 1050 1580 1580 1580 1580 1580URINE FOR AMINO ACID CHROMATOGRAPHY(QUALITATIVE) SVC004554 2100 3150 3150 3150 3150 3150URINE FOR BJP (BENCE JONES PROTEIN) SVC003836 580 870 870 870 870 870URINE FOR CHYLE SVC004744 540 810 810 810 810 810URINE FOR DYSMORPHIC RBC SVC005409 380 570 570 570 570 570URINE FOR HAEMOSIDERIN SVC004290 370 550 550 550 550 550URINE FOR HUMAN CHORIONIC GONADOTROPIN (HCG) SVC004287 1110 1110 1110 1110 1110 1110URINE FOR MICROALBUMIN (RANDOM) SVC003846 580 870 870 870 870 870URINE FOR MICROALBUMIN TO CREATININE RATIO SVC004291 650 980 980 980 980 980URINE FOR OPIATES (RANDOM) SVC004673 680 1020 1020 1020 1020 1020URINE FOR ORGANIC ACID (GC/MS) SVC004457 3680 5510 5510 5510 5510 5510URINE FOR PORPHOBILINOGEN SVC004294 4360 6540 6540 6540 6540 6540URINE FOR TOXICOLOGY SCREENING SVC004297 4000 6000 6000 6000 6000 6000URINE FOR VMA (SPOT) SVC004745 4040 6060 6060 6060 6060 6060URINE LEGIONELLA ANTIGEN SVC005667 10080 15120 15120 15120 15120 15120URINE METANEPHRINES (RANDOM) SVC003854 11340 17010 17010 17010 17010 17010URINE MPS QUANTITATIVE SVC004967 3470 5200 5200 5200 5200 5200

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteURINE OSMOLALITY (CALCULATED) SVC003855 800 1200 1200 1200 1200 1200URINE OSMOLALITY (MEASURED) SVC005116 430 650 650 650 650 650URINE TBPCR SVC004299 3310 4960 4960 4960 4960 4960VALPROIC ACID SVC004300 840 1260 1260 1260 1260 1260VANCOMYCIN SVC004301 4750 7130 7130 7130 7130 7130VARICELLA ANTIBODIES (IGM & IGG) SVC004302 2210 3320 3320 3320 3320 3320VARICELLA IGG ANTIBODY SVC004303 1240 1860 1860 1860 1860 1860VARICELLA ZOSTER IGM SVC004304 1260 1890 1890 1890 1890 1890VGKC (VOLTAGE GATED POTASSIUM CHANNEL), ANTIBODY SVC005881 7350 11030 11030 11030 11030 11030VITAMIN A (RETINOL) SVC004305 4200 6300 6300 6300 6300 6300VITAMIN B12, ACTIVE; HOLOTRANSCOBALAMIN SVC005439 1680 2520 2520 2520 2520 2520VITAMIN B2 (RIBOFLAVIN) SVC004950 8350 12520 12520 12520 12520 12520VITAMIN B6 SVC004306 2150 3230 3230 3230 3230 3230VITAMIN D 1,25 DIHYDROX SVC005057 3360 5040 5040 5040 5040 5040VITAMIN D 1,25 DIHYDROXY (VITAMIN D3) SVC004307 3700 5550 5550 5550 5550 5550VWF (VON WILLIBRANDS ANTIGEN) SVC004308 10500 15750 15750 15750 15750 15750WATER CULTURE (MPN METHOD) SVC004779 1100 1650 1650 1650 1650 1650WEIL FELIX TEST SVC004309 930 1400 1400 1400 1400 1400WESTERN BLOT (HIV CONFIRMATORY) SVC004310 3350 5030 5030 5030 5030 5030WHOLE EXOME SEQUENCING SVC005212 54180 81270 81270 81270 81270 81270

LIVER TRANSPLANT (RECIPIENT) - A PKG PKG004517 1800000 1800000 1800000LIVER TRANSPLANT (RECIPIENT) - B PKG PKG004518 2000000 2000000 2000000ANAL DILATATION SVC007898 5400 7100 8100 9200 10300ANAL TRANSPOSITION SURGERY SVC007920 23600 30700 35400 40200 44900ANOPLASTY SVC007765 20600 26800 30900 35100 39200BILATERAL INGUINAL HERNIOTOMIES SVC007767 21000 27300 31500 35700 39900BLADDER AUGMENTATION SVC007768 65800 85600 98700 111900 125100BONE MARROW ASPIRATION - PEDIATRIC SVC007764 4100 5400 6200 7000 7800BRONCHOSCOPY - FOREIGN BODY REMOVAL SVC007922 12500 16300 18800 21300 23800CIRCUMCISION - PEDIATRIC SVC007772 7600 9900 11400 13000 14500COLOSTOMY SVC007925 23600 30700 35400 40200 44900

Liver Transplant

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteCYST EXCISION SVC007971 8100 10600 12200 13800 15400DIAGNOSTIC BRONCHOSCOPY SVC007928 9900 12900 14900 16900 18900DIAGNOSTIC CYSTOSCOPY / PANENDOSCOPY SVC007929 8100 10600 12200 13800 15400DISTAL PANCREATECTOMY - PEDIATRIC SURGERY SVC007777 40500 52700 60800 68900 77000DRAINAGE OF PSEUDO PANCREATIC CYST SVC007778 27200 35400 40800 46300 51700ENCEPHALOCELE -EXCISION & REPAIR SVC007779 40500 52700 60800 68900 77000ENCEPHALOCELE SURGERY SVC007930 40500 52700 60800 68900 77000FASCIOTOMY SVC007789 16500 21500 24800 28100 31400FEEDING GASTROSTOMY SVC007790 13900 18100 20900 23700 26500GASTROSTOMY SVC007793 24800 32300 37200 42200 47200GASTROSTOMY / JEJUNOSTOMY LAPROSCOPIC SVC007934 21300 27700 32000 36300 40500GENITOSCOPY SVC007905 700 1000 1100 1200 1400HELLER'S CARDIOMYOTOMY(OPEN) SVC007875 28900 37600 43400 49200 55000HEMITHYROIDECTOMY SVC007794 23000 29900 34500 39100 43700HERNIOTOMIES (UMBILICAL / INGUINAL) SVC007795 14800 19300 22200 25200 28200HYDROCELE UNILATERAL LAPROSCOPIC SVC007937 13200 17200 19800 22500 25100ILEOSTOMY SVC007938 17100 22300 25700 29100 32500INTUSSUSCEPTION REDUCTION (PNEUMATIC) SVC007799 30300 39400 45500 51600 57600LAPAROSCOPIC COLOSTOMY SVC007864 18000 23400 27000 30600 34200LAPAROSCOPIC NEPHROURETERECTOMY (UNILATERAL) SVC007859 56900 74000 85400 96800 108200LAPAROSCOPIC ORCHIDOPEXY SVC007802 32400 42200 48600 55100 61600LAPAROTOMY + ADHESIOLYSIS SVC007908 20700 27000 31100 35200 39400LIMITED POSTERIOR SAGITTAL ANORECTOPLASTY(PSARP) SVC007963 27500 35800 41300 46800 52300LIVER TRANSPLANT (RECIPIENT) - C PKG PKG004519 2200000 2200000 2200000MECKELS DIVERTICULECTOMY SVC007812 18200 23700 27300 31000 34600MESENTRIC CYST EXCISION SVC007897 22200 28900 33300 37800 42200MUSCLE BIOPSY SVC007871 3900 3900 5100 5900 6700 7500NEPHRECTOMY SVC007814 31600 41100 47400 53800 60100OPERATIVE CHOLANGIOGRAM / OPEN LIVER BIOPSY SVC007816 5800 5800 7600 8700 9900 11100PAROTIDECTOMY - SUPERFICIAL SVC007817 23000 29900 34500 39100 43700PAROTIDECTOMY -TOTAL SVC007818 28800 37500 43200 49000 54800RADICAL NEPHRO-URETERECTOMY SVC007913 45400 59100 68100 77200 86300

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteRECTAL POLYPECTOMY SVC007824 9300 12100 14000 15900 17700RECTAL PROLAPSE (SCLEROTHERAPY / THIERSCH WIRE) SVC007825 23100 30100 34700 39300 43900RECTOPEXY SVC007826 32900 42800 49400 56000 62600SPLENORRHAPHY SVC007830 25500 33200 38300 43400 48500STERNOMASTOID RELEASE SVC007831 9800 12800 14700 16700 18700SUPRAPUBIC CYSTOSTOMY SVC007951 9900 12900 14900 16900 18900SURGICAL CORRECTION OF CONGENITAL HYPERTOPHIC PYLORIC STENOSIS SVC007836 22700 29600 34100 38600 43200SUTURING OF LACERATION SVC007866 6300 8200 9500 10800 12000THORACOTOMY SVC007844 32900 42800 49400 56000 62600TONGUE TIE RELEASE SVC007845 4700 6200 7100 8000 9000TOTAL THYROIDECTOMY SVC007846 28900 37600 43400 49200 55000UNILATERAL ORCHIDOPEXY SVC007865 19800 25800 29700 33700 37700URETHROCUTANEOUS FISTULA CLOSURE SVC007909 25500 33200 38300 43400 48500LIVER TRANSPLANT RECIPIENT - LIFETIME FOLLOW-UP FEES SVC003189 100000 100000 100000 100000 100000 100000LAPAROSCOPIC SMALL BOWEL RESECTION SVC006884 44500 57900 66800 75700 84600

ADJUVANT SVC006830 4700 6200 7100 8000 9000BONE MARROW ASPIRATION & BIOPSY SVC006860 7700 7700 10100 11600 13100 14700BONE MARROW BIOPSY SVC006859 4700 4700 6200 7100 8000 9000CAUDAL EPIDURAL STEROID INJECTION SVC006789 8700 11400 13100 14800 16600CHEMO PLANNING AND PROTOCOL CHARGES_ SVC011928 16170 21030 24260 27490 30730CHEMO TRANSFUSION & MONITORING CHARGES (PER DAY) SVC006834 3200 4200 4800 5500 6100CHEMOPORT CARE & FLUSHING SVC006835 900 1200 1400 1600 1800CHEMOTHERAPHY PROTOCOL CHARGES-A SVC006810 11100 14500 16700 18900 21100CHEMOTHERAPY CHARGES - BIOLOGICALS SVC006820 7800 10200 11700 13300 14900CHEMOTHERAPY CONTINUOUS INFUSION SVC006861 10400 13600 15600 17700 19800CHEMOTHERAPY PLANNING CHARGES SVC006812 6700 8800 10100 11400 12800CVP INSERTION / PICC INSERTION SVC006848 4700 6200 7100 8000 9000INTRA OMMAYA RESERVOIR SVC006846 11600 15100 17400 19800 22100INTRATHECAL CHEMOTHERAPY SVC006829 5800 7600 8700 9900 11100INTRATHECAL-DIAGNOSTICS SVC006862 4100 5400 6200 7000 7800

Medical Oncology

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IV PUSH/IM CHEMO/HORMONAL AGENT ADMINISTRATION ONLY SVC006827 1500 2000 2300 2600 2900LUMBAR TRANSFORAMINAL EPIDURAL INJECTION SVC006784 15900 20700 23900 27100 30300MULTIPLE DRUGS SVC006832 8100 10600 12200 13800 15400PICC LINE CATHETER CARE & FLUSHING SVC006836 900 1200 1400 1600 1800SEROMA ASPIRATION. SVC006868 2400 3200 3600 4100 4600SINGLE DRUGS SVC006833 3500 4600 5300 6000 6700TRIGEMINAL GANGLION INJECTION (DIAGNOSTIC) SVC006803 23100 30100 34700 39300 43900ULTRASOUND GUIDED CENTRAL LINE INSERTION SVC006813 7700 10100 11600 13100 14700ZOLEDRONIC ACID ADMINISTRATION SVC006828 1800 2400 2700 3100 3500

CONTINUOUS RENAL REPLACEMENT THERAPY (CRRT) FOR 12 HRS SVC011626 7200 9400 10800 12300 13700CONTINUOUS RENAL REPLACEMENT THERAPY (CRRT) PER DAY SVC011625 12900 16800 19400 22000 24600DIALYSIS (SERO-POSITIVE PATIENT) SVC006287 2700 2700 3600 4100 4600 5200DIALYSIS (SINGLE USE ) SVC006286 3000 3000 3900 4500 5100 5700DIALYSIS HDF PKG PKG016184 4400 4400 5800 6600 7500 8400DIALYSIS HI FLEX PKG PKG016181 4000 4000 5200 6000 6800 7600DIALYSIS RE-USE PKG PKG016182 2400 2400 3200 3600 4100 4600DIALYSIS SHEATH INSERTION SVC006276 3300 3300 4300 5000 5700 6300DIALYSIS SINGLE USE PKG PKG016180 3000 3000 3900 4500 5100 5700DIALYSIS SLED PKG PKG016183 4400 4400 5800 6600 7500 8400FEMORAL CATHETERIZATION SVC006280 2800 2800 3700 4200 4800 5400JUGULAR DOUBLE LUMEN CATHETERIZATION SVC006304 3200 3200 4200 4800 5500 6100KIDNEY BIOPSY ( USING NEW GUN ) SVC006268 8400 8400 11000 12600 14300 16000PERITONEAL DIALYSIS SVC006271 4200 4200 5500 6300 7200 8000PLASMAPHARESIS SVC006274 17300 22500 26000 29500 32900Pre-workup Kidney Transplant Donor PKG016186 46200 46200 60100 69300 78600 87800Pre-workup Kidney Transplant Recipient PKG016185 69300 69300 90100 104000 117900 131700RENAL TRANSPLANT (RECIPIENT) - RELATED PKG PKG004158 450000 450000 450000SUSTAINED LOW EFFICIENCY DIALYSIS (SLED) 6 HOURS SVC006305 4400 4400 5800 6600 7500 8400HAEMODIALYSIS SVC006275 1800 2700 3510 4050 4590 5130

Nephrology

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteHAEMODIALYSIS (WITH NEW DIALYZER) SVC006283 2800 4200 5460 6300 7140 7980HAEMODIALYSIS PKG PKG016177 2090 2090 2720 3140 3550 3970

BAER SVC006316 2490 3240 3740 4240 4490 4740BOTOX INJECTION TYPE 1 SVC006392 2700 2700 3600 4100 4600 5200BOTOX INJECTION TYPE 2 SVC006391 5100 5100 6700 7700 8700 9700BURR HOLE AND ASPIRATION OF ABSCESS (SINGLE) SVC006416 8300 8300 10800 12500 14200 15800CONTINOUS RENAL REPLACEMENT THERAPY (CRRT) INITIATION CHARGES SVC006291 12800 12800 16700 19200 21800 24400CP ANGLE TUMOR SVC006430 104300 104300 135600 156500 177400 198200DERMOID SVC006427 3700 3700 4900 5600 6300 7100DIGITAL SUBSTRACTION ANGIOGRAM (DSA OR CEREBRAL ANGIOGRAM) SVC006390 12800 12800 16700 19200 21800 24400EEG SVC006317 3070 4000 4610 5220 5530 5840EEG - R SVC006371 1700 1700 2300 2600 2900 3300EEG 12HR SVC006443 11550 15020 17330 19640 20790 21950EEG 24HR SVC006444 17330 22530 26000 29470 31200 32930EEG 2HR SVC006440 3470 4520 5210 5900 6250 6600EEG 48 HR SVC006445 23100 30030 34650 39270 41580 43890EEG 4HR SVC006441 4620 6010 6930 7860 8320 8780EMG WITH NCV B/L LL SVC006435 4300 4300 5600 6500 7400 8200EMG WITH NCV B/L UL SVC006434 4300 4300 5600 6500 7400 8200EMG WITH NCV-ALL FOUR LIMBS SVC006449 5600 5600 7300 8400 9600 10700LUMBAR PUNCTURE WITH CSF MONITORING SVC006318 1800 1800 2400 2700 3100 3500NCV - FOUR LIMBS SVC006319 5670 7380 8510 9640 10210 10780NCV - TWO LIMBS SVC006320 4310 5610 6470 7330 7760 8190NCV FACIAL SVC006321 1830 2380 2750 3120 3300 3480NCV SINGLE NERVE SVC006394 1660 2160 2490 2830 2990 3160NCV WITH EMG- BRACHIAL PLEXIS SVC006447 5000 5000 6500 7500 8500 9500NCV WITH EMG- LUMBAR PLEXIS SVC006448 5200 5200 6800 7800 8900 9900NEEDLE EMG - 3-4 MUSCLES SVC006384 1800 1800 2400 2700 3100 3500NEOSTIGMINE TEST SVC006376 5400 5400 7100 8100 9200 10300

Neurology

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteNERVE BIOPSY SVC006382 4000 4000 5200 6000 6800 7600PARENT VESSEL OCCLUSION SVC003438 36400 36400 47400 54600 61900 69200RNS (REPETITIVE NERVE STIMULATION) SVC006327 1990 2590 2990 3390 3590 3790SKULL TRACTION SVC006407 10600 10600 13800 15900 18100 20200SSEP SVC006377 2500 2500 3300 3800 4300 4800USE OF SKULL BASE APPROACH FOR TUMOR RESECTION SVC006429 75100 75100 97700 112700 127700 142700VEEG - II SVC006378 5700 5700 7500 8600 9700 10900VEEG - III SVC006379 6700 6700 8800 10100 11400 12800VEEG - IV SVC006380 11700 11700 15300 17600 19900 22300VEEG-I SVC006370 3190 4150 4790 5430 5750 6070VISUALLY EVOKED POTENTIAL (VEP) SVC006369 3360 4370 5040 5720 6050 6390

BONE FLAP REMOVAL SVC006566 13900 18100 20900 23700 26500Brachial Plexus Injury - Simple SVC013224 31500 41000 47300 53600 59900BRACHIAL PLEXUS REPAIR (PERIPHERAL NERVE LEVEL) SVC006541 52000 67600 78000 88400 98800BRACHIAL PLEXUS REPAIR (ROOT LEVEL) SVC006542 63600 82700 95400 108200 120900Brachial Plexus Surgery SVC013225 47300 61500 71000 80500 89900BRACHIAL PLEXUS TUMOR EXCISION SVC006462 57800 75200 86700 98300 109900BRACHIAL PLEXUS TUMOR EXCISION (ROOT LEVEL) SVC006556 63600 82700 95400 108200 120900BRAIN ABSCESS TAPPING SVC006463 3500 3500 4600 5300 6000 6700BRAIN ABSCESS TAPPING (COMPLEX) SVC006630 11600 15100 17400 19800 22100Burr Hole - Single SVC013226 7900 10300 11900 13500 15100C.S.F. RHINORRHAEA SVC006619 33300 43300 50000 56700 63300C.V. JUNCTION FUSION SVC006592 71700 93300 107600 121900 136300CAROTID ENDARTECTOMY SVC006464 57800 75200 86700 98300 109900CARPAL TUNNEL RELEASE SVC006465 21500 28000 32300 36600 40900CERVICAL CORPECTOMY WITH FUSION SVC006466 52000 67600 78000 88400 98800CERVICAL CORPECTOMY WITH FUSION (TWO LEVELS) SVC006557 63600 82700 95400 108200 120900CERVICAL DISC ARTHROPLASTY SVC006615 30100 39200 45200 51200 57200CERVICAL DISCECTOMY (MULTIPLE LEVELS) SVC006555 57800 75200 86700 98300 109900CERVICAL LAMINECTOMY & STABILIZATION SVC006649 54300 70600 81500 92400 103200CHRONIC SUBDURAL HEMATOMA (UNILATERAL) SVC006558 40500 52700 60800 68900 77000

Neurosurgery

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteCHRONIC SUBDURAL HEMATOMA COMPLEX / BILATERAL SVC006468 52000 67600 78000 88400 98800CLIPPING OF ANEURYSM-MULTIPLE/COMPLEX SVC006650 86700 112800 130100 147400 164800CRANIOPLASTY SVC006471 57800 75200 86700 98300 109900CRANIOSYNOSTOSIS SVC006472 57800 75200 86700 98300 109900CRANIOSYNOSTOSIS (COMPLEX) SVC006638 63600 82700 95400 108200 120900CRANIOTOMY AND EVACUATION OF HAEMATOMA SVC006602 57800 75200 86700 98300 109900CRANIOTOMY AND EVACUATION OF HAEMATOMA - SUBDURAL SVC006616 69900 90900 104900 118900 132900CRANIOTOMY AND EXCISION OF INTRAORBITAL TUMOR SVC006612 52000 67600 78000 88400 98800CRANIOTOMY FOR BRAIN TUMOR SVC006651 59000 76700 88500 100300 112100CRANIOTOMY FOR BRAIN TUMOR-COMPLEX SVC006652 69300 90100 104000 117900 131700CRANIOTOMY FOR CLIPPING OF ANEURYSM / AVAL / AVM SVC006503 74000 96200 111000 125800 140600CSF FISTULA REPAIR SVC006607 17400 22700 26100 29600 33100DECOMPRESSIVE CRANIOTOMY WITH DUROPLASTY SVC006574 46200 60100 69300 78600 87800Deep Brain Lesioning SVC013230 85100 110700 127700 144700 161700DEEP BRAIN STIMULATION SVC006591 86700 112800 130100 147400 164800DEPRESSED FRACTURE ELEVATION AND DECOMPRESSION SVC006610 40500 52700 60800 68900 77000DORSAL SPINAL DECOMPRESSION SVC006595 72800 94700 109200 123800 138400DORSAL SPINAL TUMOR EXCISION SVC006596 87300 113500 131000 148500 165900ELEVATION OF DEPRESSED FRACTURE AND DURAPLASTY SVC006517 52000 67600 78000 88400 98800ENDOSCOPIC EXTENDED APPROACH FOR SKULL BASE TUMOR SVC006653 75100 97700 112700 127700 142700ENDOSCOPIC PITUITARY SURGERY SVC006559 59000 76700 88500 100300 112100ENDOSCOPIC REPAIR OF CSF RHINORRHEA SVC006475 52000 67600 78000 88400 98800ENDOSCOPIC THIRD VENTRICULOSTOMY SVC006476 57800 75200 86700 98300 109900Entrapment Neuropathy Decompression - Level A SVC013231 27300 35500 41000 46500 51900Entrapment Neuropathy Decompression - Level B SVC013232 52500 68300 78800 89300 99800EPILEPSY SURGERY MTS SVC006478 52000 67600 78000 88400 98800EVD (EXTERNAL VENTRICULAR DRAIN) INSERTION SVC006528 17400 22700 26100 29600 33100Facet Block - Multiple ( Neurosurgery ) SVC013233 10500 13700 15800 17900 20000Facet Block -Single ( Neurosurgery ) SVC013234 5300 6900 8000 9100 10100Facial Reinnervation - Complex SVC013235 52500 68300 78800 89300 99800Facial Reinnervation - Simple SVC013236 36800 47900 55200 62600 70000Fenestration - Spine SVC013237 21000 27300 31500 35700 39900

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteFORAMEN MAGNUM DECOMPRESSION SVC006481 46200 60100 69300 78600 87800ICP MONITORING SVC006482 3000 3900 4500 5100 5700Image Guided Biopsy SVC013238 54600 54600 71000 81900 92900 103800IMPLANT REMOVAL SVC006585 7100 9300 10700 12100 13500INTRATHECAL BACLOFEN PUMP IMPLANTATION SVC006484 28900 37600 43400 49200 55000Laceration Suturing ( Neurosurgery ) SVC013239 4200 5500 6300 7200 8000LAMINECTOMY (C1-C2) SVC006563 46500 60500 69800 79100 88400LAMINECTOMY TUMOR MULTIPLE LEVEL LARGE SVC006576 54500 70900 81800 92700 103600LUMBAR DRAIN SVC006531 6500 8500 9800 11100 12400LUMBAR REGION TUMOUR EXCISION SVC012899 57800 75200 86700 98300 109900LUMBAR SPINAL DECOMPRESSION AND FIXATION SVC006598 48300 62800 72500 82200 91800LUMBAR SPINAL LAMINECTOMY SVC006599 52000 67600 78000 88400 98800LUMBOPERITONEAL SHUNT SVC006519 23100 30100 34700 39300 43900MICROVASCULAR DECOMPRESSION SVC006609 52000 67600 78000 88400 98800MULTIPLE BURR HOLE SVC006640 46800 60900 70200 79600 89000NERVE TRANSPOSITION SVC006521 15100 19700 22700 25700 28700ORIF MANDIBLE SVC006629 25300 32900 38000 43100 48100Percutaneous Transpedicular Biopsy ( Neurosurgery ) SVC013240 26300 26300 34200 39500 44800 50000PERIPHERAL NERVE SURGERY SVC006488 40500 52700 60800 68900 77000PERIPHERAL NERVE SURGERY - MAJOR SVC006624 46200 60100 69300 78600 87800

PERIPHERAL NERVE SURGERY (NERVE REPAIR WITH NERVE GRAFT) SVC006544 47200 61400 70800 80300 89700Posterior Spinal Instrumentation Removal SVC013241 12600 16400 18900 21500 24000PROGRAMMABLE VP SHUNT SVC006618 61700 80300 92600 104900 117300

RADIO FREQUENCY LESIONIONING FOR TRIGEMINAL NEURALGIA SVC006623 23100 30100 34700 39300 43900RESECTION OF SPINAL EXTRAMEDULLARY SIMPLE TUMOR SVC006490 57800 75200 86700 98300 109900RHINOPLASTY SVC012517 36200 47100 54300 61600 68800Scalp Avulsion Laceration Suturing SVC013242 12600 16400 18900 21500 24000SCALP REPAIR SVC006608 8100 10600 12200 13800 15400SCALP TUMOR EXCISION - MINOR SVC006600 11600 15100 17400 19800 22100Shunt Revision - Level B ( Neurosurgery ) SVC013243 42000 54600 63000 71400 79800

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteShunt Revision ( Level A ) SVC013244 26300 34200 39500 44800 50000SKULL BASE TUMOR EXCISION ENDOSCOPIC SVC006506 75100 97700 112700 127700 142700SPINA BIFIDA SURGERY MAJOR SVC006625 22000 28600 33000 37400 41800Spinal Cord Stimulator Implantation SVC012597 36800 47900 55200 62600 70000Spinal Decompression - Level AÂ ( Neurosurgery ) SVC013246 31500 41000 47300 53600 59900Spinal Decompression - Level BÂ ( Neurosurgery ) SVC013247 48300 62800 72500 82200 91800Spinal Decompression -Â Level CÂ ( Neurosurgery ) SVC013245 73500 95600 110300 125000 139700SPINAL EXTRADURAL TUMOR SVC006550 87300 113500 131000 148500 165900SPINAL EXTRAMEDULLARY COMPLEX TUMORS SVC006538 57800 75200 86700 98300 109900SPINAL FUSION SVC006564 56400 73400 84600 95900 107200Spinal Fusion Level B ( Neurosurgery ) SVC013248 67200 87400 100800 114300 127700Spinal Fusion Level C ( Neurosurgery ) SVC013249 86100 112000 129200 146400 163600SPINAL INTRA MEDULLARY TUMORS SVC006491 71700 93300 107600 121900 136300SPINE BIFIDA MINOR (FILUM ONLY) SVC006492 17400 22700 26100 29600 33100STEREOTACTIC BIOPSY SVC006493 57800 57800 75200 86700 98300 109900SURGERY MANAGEMENT OF SPASTICITY SVC011768 84000 109200 126000 142800 159600SURGICAL MANAGEMENT OF SPINAL DYSRAPHISM SVC006496 57800 75200 86700 98300 109900SURGICAL MANAGEMENT OF SPINAL DYSRAPHISM (COMPLEX) SVC006636 87300 113500 131000 148500 165900SURGICAL TREATMENT OF MENINGOENCEPHALOCELE SVC006497 52000 67600 78000 88400 98800THE CO-PERITONEAL SHUNT SVC006611 47300 61500 71000 80500 89900TRACHEOSTOMY CHANGE SVC006532 800 800 1100 1200 1400 1600Transforaminal Epidural Nerve Block Lumbar ( Multipe ) SVC013250 8400 11000 12600 14300 16000Transforaminal Epidural Nerve Block Lumbar ( Single ) SVC013251 4500 5900 6800 7700 8600Trigeminal Rhizotomy SVC013252 47300 61500 71000 80500 89900VENTRICULO PERITONIAL / VENTRCULO ATRIAL SHUNT SVC006567 34700 45200 52100 59000 66000VENTRICULOATRIAL SHUNT SVC006546 55500 72200 83300 94400 105500Vessel ligation - Parent ( Neurosurgery ) SVC013253 29400 38300 44100 50000 55900V-P SHUNT REMOVAL SVC006613 15100 19700 22700 25700 28700

BONE SCAN SVC006208 7510 9770 11270 12770 13520 14270DMSA SVC006213 7630 9920 11450 12980 13740 14500DTPA SVC006215 7630 9920 11450 12980 13740 14500

Nuclear Medicine

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteGA 68 PSMA PET CT SVC006260 37000 37000 48100 55500 62900 70300HIDA SCAN (HEPATOBILIARY SCAN) SVC006222 7560 9830 11340 12860 13610 14370PARATHYROID SCAN SVC006228 12130 15770 18200 20630 21840 23050PET CT SCAN (WITH CONTRAST) SVC006231 33270 43260 49910 56560 59890 63220PET CT SCAN (WITHOUT CONTRAST) SVC006255 24260 31540 36390 41250 43670 46100THYROID SCAN SVC006251 3040 3960 4560 5170 5480 5780

ABDOMINAL MYOMECTOMY ( MULTIPLE) SVC006724 43200 56200 64800 73500 82100BILATRAL SALPINGO OPHERECTOMY (BSO) SVC006744 72500 94300 108800 123300 137800CERVICAL CAUTERIZATION SVC006752 5800 7600 8700 9900 11100COLPOSCOPY (DIAGNOSTIC+BIOPSY) SVC006748 6300 6300 8200 9500 10800 12000CYSTOCOELE REPAIR SVC006707 13200 17200 19800 22500 25100CYTOREDUCTIVE SURGERY SVC006747 104100 135400 156200 177000 197800DIAGNOSTIC HYSTERO LAPAROSCOPY SVC006713 2000 2600 3000 3400 3800ENDOMETRIOSIS - EXCISION OF SCAR SVC006703 47100 61300 70700 80100 89500EXCISION OF RUDIMENTARY HORN OF UNICORNUATE UTERUS SVC012886 58300 75800 87500 99200 110800EXENTERATION ANTERIOR SVC012887 86700 112800 130100 147400 164800EXENTERATION POSTERIOR SVC012888 86700 112800 130100 147400 164800GROIN NODE DISSECTION - B/L SVC006749 72700 94600 109100 123600 138200GROIN NODE DISSECTION - U/L SVC006750 42400 55200 63600 72100 80600HEMI VULVECTOMY SVC011693 24100 31400 36200 41000 45800HYSTEROSCOPIC TUBAL CANNULATION SVC006710 18000 23400 27000 30600 34200HYSTEROSCOPY IUCD REMOVAL SVC006696 19300 25100 29000 32900 36700LAMAZE SESSION SVC006711 4100 5400 6200 7000 7800LAMAZE SESSION PER SESSION SVC006712 2400 3200 3600 4100 4600LAP SALPINGECTOMY SVC006709 42300 55000 63500 72000 80400LAPAROSCOPIC EXENTERATION (ANTERIOR) SVC012892 95300 123900 143000 162100 181100LAPAROSCOPIC EXENTERATION (POSTERIOR) SVC012893 95400 124100 143100 162200 181300LAPAROSCOPIC EXENTERATION (TOTAL) SVC012894 118900 154600 178400 202200 226000LAPAROSCOPIC OVIRIAN TRANSPOSITION SVC012895 36200 47100 54300 61600 68800LAPAROSCOPIC SURGERY FOR CARCINOMA OF OVARY SVC012896 34700 45200 52100 59000 66000LAPAROSCOPIC TUBAL LIGATION SVC006720 3700 4900 5600 6300 7100

Obstetrics

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteLAPAROSOCPIC HYSTERECTOMY WITHOUT BSO SVC006714 42400 55200 63600 72100 80600LAPAROTOMY - A SVC006715 6200 8100 9300 10600 11800LAPAROTOMY - B SVC006716 41100 53500 61700 69900 78100LASER EXCISION OF VAGINAL LESION SVC012898 14900 19400 22400 25400 28400OMENTECTOMY + PERITONECTOMY SVC012903 64000 83200 96000 108800 121600OPEN SURGERY FOR ECTOPIC PREGNANCY SVC006718 36300 47200 54500 61800 69000OVARIAN BIOPSY SVC006723 10300 10300 13400 15500 17600 19600OVARIAN TRANSPOSITION SVC012904 30400 39600 45600 51700 57800PELVIC LYMPHADENECTOMY SVC012905 42400 55200 63600 72100 80600PERITONECTOMY SVC012906 25600 33300 38400 43600 48700RADICAL HYSTERECTOMY - LAPAROSCOPIC SVC006739 80000 104000 120000 136000 152000Radical Trachelectomy - Laparoscopic SVC012911 42400 55200 63600 72100 80600RADICAL TRACHELECTOMY + LAPAROSCOPIC PELVIC LYMPHADENECTOMY SVC012912 80000 104000 120000 136000 152000RADICAL TRACHELECTOMY + PELVIC LYMPHADENECTOMY SVC012913 76000 98800 114000 129200 144400RADICAL VULVECTOMY + INGUINO FEMORAL LYMPHADENECTOMY - B/L SVC012914 96800 125900 145200 164600 184000RADICAL VULVECTOMY + INGUINO FEMORAL LYMPHADENECTOMY - U/L SVC012915 66500 86500 99800 113100 126400REPEAT COMPLETE PERINEAL TEAR REPAIR SVC006697 10400 13600 15600 17700 19800RETRO PERITONEAL LYMPH NODE BIOPSY SVC006701 25600 25600 33300 38400 43600 48700RETROPERITONEAL LYMPH NODE DISSECTION - LAPAROSCOPIC (RPLND-L) SVC006740 108800 141500 163200 185000 206800RIGHT PELVIC LYMPH NODE REPAIR (RPLND) SVC006734 56500 73500 84800 96100 107400SECOND LOOK LAPAROTOMY SVC006726 25600 33300 38400 43600 48700SURGICAL STAGING FOR ENDOMETRIAL CANCER SVC012917 76000 98800 114000 129200 144400TAH & LAP SALPINGO - OOPHERECTOMY SVC012918 25600 33300 38400 43600 48700TOTAL ABDOMINAL HYSTERECTOMY (TAH) + BILATERAL SALPINGO-OOPHORECTOMY (BSO) + NODE SAMPLING SVC011918 50600 65800 75900 86100 96200TOTAL ABDOMINAL HYSTERECTOMY (TAH) + BILATERAL SALPINGO-OOPHORECTOMY (BSO) + OMENTECTOMY SVC006746 50600 65800 75900 86100 96200

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TOTAL ABDOMINAL HYSTERECTOMY (TAH) + BILATERAL SALPINGO-OOPHORECTOMY (BSO) + OMENTO + NODE DISSECTION SVC012919 76000 98800 114000 129200 144400

TOTAL ABDOMINAL HYSTERECTOMY (TAH) + BILATERAL SALPINGO-OOPHORECTOMY (BSO) + PELVIC LYMPHADENECTOMY SVC006751 64000 83200 96000 108800 121600TOTAL ABDOMINAL HYSTERECTOMY (TAH) + BILATERAL SALPINGO-OOPHORECTOMY (BSO) + PELVIC LYMPHADENECTOMY + PARA-AORTIC LYMPHADENECTOMY SVC012920 76000 98800 114000 129200 144400TOTAL ABDOMINAL HYSTERECTOMY WITH BILATERAL SALPINGO OOPHORECTOMY SVC006745 48700 63400 73100 82800 92600TOTAL LAPROSCOPIC HYSTERECTOMY SVC006729 53500 69600 80300 91000 101700TOTAL LAPROSCOPIC HYSTERECTOMY +BILATRAL SALPINGO OPHERECTOMY( BSO) SVC006737 67000 87100 100500 113900 127300TRANSCERVICAL RESECTION OF ENDOMETRIUM SVC006721 26400 34400 39600 44900 50200TUBOPLASTY SVC012922 13600 17700 20400 23200 25900USG GUIDED DILATATION & CURETTAGE (D&C) SVC012923 18300 23800 27500 31200 34800VAGINAL BIOPSY SVC006692 5000 5000 6500 7500 8500 9500VAGINAL HYSTERECTOMY SVC006700 32400 42200 48600 55100 61600VAGINECTOMY SVC012924 25100 32700 37700 42700 47700VAULT BIOPSY SVC006693 5000 5000 6500 7500 8500 9500VAULT PROLAPSE ABDOMINAL REPAIR SVC006742 46200 60100 69300 78600 87800VULVAL BIOPSY SVC006694 7600 7600 9900 11400 13000 14500

Collagen Cross Linking C3R SVC014002 16000 16000 20800 24000 27200 30400ABSCESS DRAINAGE OF LID SVC007060 4000 5200 6000 6800 7600AVASTIN INJECTION SVC006982 4900 6400 7400 8400 9400B SCAN SONOGRAPHY(BOTH EYE) SVC007072 1740 2270 2610 2960 3140 3310B SCAN SONOGRAPHY(ONE EYE) SVC007071 930 1210 1400 1590 1680 1770CAPSULOTOMY SVC007063 4700 6200 7100 8000 9000COLONIC STRICTURE DILATATION SVC002824 12600 16400 18900 21500 24000COLOUR VISION SVC006987 300 300 400 500 600 600

Opthalmology

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteCONJUNCTIVAL LACERATION REPAIR SVC007113 4700 6200 7100 8000 9000CONJUNTIVAL FLAP SVC007065 8800 11500 13200 15000 16800CORNEAL TEAR SUTURING - MINOR SVC007095 13900 18100 20900 23700 26500CORNEO SCLERAL LACERATION REPAIR SVC007064 20800 27100 31200 35400 39600CYCLOCRYOTHERAPY (CCT) SVC006970 3500 4600 5300 6000 6700DACRYOCYSTORHINOSTOMY SVC006965 19700 25700 29600 33500 37500DIURNAL VARIATION SVC007110 1100 1500 1700 1900 2100ECTROPIAN SVC007075 14500 18900 21800 24700 27600ENTROPION SVC007076 14800 19300 22200 25200 28200ENUCLEATION SVC006980 16800 21900 25200 28600 32000EVISCERATION SVC006955 11600 15100 17400 19800 22100EXCISION OF EYELID MASS SVC006978 17400 22700 26100 29600 33100EXCISION OF PTERYGIUM WITH LIMBAL AUTOGRAFT SVC006956 5600 5600 7300 8400 9600 10700EXCISSION OF PTERYGIUM SVC007023 5800 5800 7600 8700 9900 11100EXPLORATION SYRINGING TEAR DUCTS(OPD) SVC007116 1800 1800 2400 2700 3100 3500FUNDOSCOPY SVC006968 930 1210 1400 1590 1680 1770FUNDUS FLUROSCEIN ANGIOGRAM SVC006963 2310 3010 3470 3930 4160 4390FUNDUS PHOTOGRAPHY SVC007111 1000 1000 1300 1500 1700 1900GENERAL ANAESTHESIA/EXAMINATION UNDER ANAESTHESIA SVC007026 3500 3500 4600 5300 6000 6700HUMPHREY VISUAL FIELD EXAMINATION SVC006964 1230 1600 1850 2100 2220 2340INTRAVITREAL INJECTION SVC006971 1700 1700 2300 2600 2900 3300IRIDECTOMY SVC013298 6300 8200 9500 10800 12000LASIK ONE EYE SVC007077 32900 42800 49400 56000 62600LATERAL ORBITOTOMY SVC006957 36700 47800 55100 62400 69800LENSECTOMY SVC006958 20700 27000 31100 35200 39400LID RECONSTRUCTION SVC006959 23400 30500 35100 39800 44500LID RECONSTRUCTION MINOR SVC006976 11600 15100 17400 19800 22100LPS RESECTION(PTOSIS SURGERY) SVC006975 18000 23400 27000 30600 34200MEMBRANECTOMY SVC007036 20700 27000 31100 35200 39400NYSTAGMUS SURGERY SVC007114 23100 30100 34700 39300 43900ORBITAL EXENTERATION SVC006974 25100 32700 37700 42700 47700ORTHOPTIC EXERCISE SVC006995 2000 2000 2600 3000 3400 3800

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuitePACHYMETRY SVC006996 1000 1000 1300 1500 1700 1900PHACOEMULSFICATION PKG PKG004330 28000 36400 42000 47600 53200PHACO-MICRO INCISION CATARACT SURGERY-(MICS)-(PRELOADED)-LENS EXTRA - PKG PKG009442 34700 45200 52100 59000 66000PROBING & SYRINGING OF THE NASOLACRIMAL DUCT SVC006960 3300 3300 4300 5000 5700 6300PTERYGIUM SVC007043 4700 4700 6200 7100 8000 9000PTERYGIUM EXCISION WITH CONJUNCTIVAL AUTOGRAFTING SVC007044 10400 13600 15600 17700 19800PTERYGIUM EXCISION WITH CONJUNCTIVAL LIMBAL AUTOGRAFTING + AMNIOTIC MEMBRANE GRAFTING SVC007066 10400 13600 15600 17700 19800PUNCTUM OCLUSSION SVC006998 3800 3800 5000 5700 6500 7300REMOVAL OF CHALAZION SVC006961 2600 2600 3400 3900 4500 5000SECONDARY SUTURING SVC007331 3500 3500 4600 5300 6000 6700

SPECTRAL DOMAIN OPTICAL COHERENCE TOMOGRAPHY CORNEA SVC007080 4100 4100 5400 6200 7000 7800

SPECTRAL DOMAIN OPTICAL COHERENCE TOMOGRAPHY MACULA SVC007078 4100 4100 5400 6200 7000 7800SPECTRAL DOMAIN OPTICAL COHERENCE TOMOGRAPHY RNFL SVC007079 4900 4900 6400 7400 8400 9400SQUINT EVALUATION SVC007005 1800 1800 2400 2700 3100 3500SQUINT UNDER GA - COMPLEX SVC007089 21400 27900 32100 36400 40700SQUINT UNDER GA - SIMPLE SVC007088 17400 22700 26100 29600 33100SUPERFICIAL FOREIGHN BODY REMOVAL (OT) SVC007067 3500 4600 5300 6000 6700SUTURE LESS VITRECTOMY SVC007119 36300 47200 54500 61800 69000SUTURE REMOVAL(EYE) SVC006972 1000 1000 1300 1500 1700 1900SYNDACTY RELEASE SIMPLE SVC007563 17000 22100 25500 28900 32300SYRINGING OF EYE SVC007115 600 600 800 900 1100 1200TARSORRHAPHY SVC006979 4700 4700 6200 7100 8000 9000TARSORRHAPHY-RELEASE SVC007117 1000 1000 1300 1500 1700 1900TONOMETRY SVC007107 200 200 300 300 400 400TRABECULECTOMY SVC007090 16000 20800 24000 27200 30400TRABECULECTOMY + MITOMYCIN SVC006981 19100 24900 28700 32500 36300TRABECULOTOMY SVC007091 17400 22700 26100 29600 33100ULTRASOUND A-SCAN SVC007112 300 300 400 500 600 600

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteXANTHOMA EXCISION (LA) (PER EYE) SVC007059 2500 2500 3300 3800 4300 4800

ABOVE ELBOW AMPUTATION SVC007387 19100 24900 28700 32500 36300ABSCESS DRAINAGE / DEBRIDEMENT - LARGE SVC007588 22900 29800 34400 39000 43600ABSCESS DRAINAGE / DEBRIDEMENT - SMALL SVC007589 4400 4400 5800 6600 7500 8400AC JOINT (ISOLATED) - ORIF SVC007603 17400 22700 26100 29600 33100ACL AND MENISCECTOMY SVC007490 36400 47400 54600 61900 69200ACL RECONSTRUCTION_PKG PKG004483 83800 109000 125700 142500 159300ADDUCTOR TENOTOMY SVC007128 7900 10300 11900 13500 15100ADDUCTOR TENOTOMY + OBTURATOR NEURECTOMY SVC007129 12500 16300 18800 21300 23800AMPUTATION - ABOVE KNEE/BELOW KNEE/THROUGH ARM/THROUGH FOREARM/THROUGH THIGH SVC007533 18800 24500 28200 32000 35800AMPUTATION - SINGLE DIGIT HAND/ FOOT SVC007604 6400 8400 9600 10900 12200ANTERIOR APPROACH AND ORIF 2 LEVELS - SPINE SVC007605 48600 63200 72900 82700 92400APPLICATION OF EXTERNAL FIXATOR (ILLIZAROV) SVC007233 31800 41400 47700 54100 60500APPLICATION OF EXTERNAL FIXATOR( OPEN FRACTURES) SVC007306 25000 32500 37500 42500 47500APPLICATION OF PLASTER CAST(UPPER LIMB /LOWER LIMB ) SVC007264 3600 3600 4700 5400 6200 6900APPLICATION OF POP CAST - BOTH LIMBS SVC007214 4400 4400 5800 6600 7500 8400APPLICATION OF POP CAST - SINGLE LIMB SVC007215 2700 2700 3600 4100 4600 5200AROUND SHOULDER -ACROMIOCLAVICULAR JOINT TBW SVC007421 20000 26000 30000 34000 38000AROUND SHOULDER -ACROMIOCLAVICULAR JOINTS PLATING SVC007439 27500 35800 41300 46800 52300ARTHRODESIS OF MINOR JOINTS SVC007388 13700 17900 20600 23300 26100ARTHROSCOPIC DEBRIDEMENT SVC007606 44300 57600 66500 75400 84200ARTHROSCOPY - DIAGNOSTIC SVC007221 13900 18100 20900 23700 26500ARTHROSCOPY- KNEE JOINT SVC007608 20800 27100 31200 35400 39600ARTHROTOMY SVC007291 11000 14300 16500 18700 20900ASPIRATION OF JOINTS SVC007134 1600 1600 2100 2400 2800 3100BIOPSY / LAVAGE / ARTHROTOMY - HIP / SHOULDER SVC007602 12300 12300 16000 18500 21000 23400BIPOLAR RELEASE TORTICOLLIS SVC011632 18500 24100 27800 31500 35200BIPOLAR RELEASE TORTICOLLIS WITH Z PLASTY SVC012927 23100 30100 34700 39300 43900BONE BIOPSY DEEP SVC007295 3700 3700 4900 5600 6300 7100BONE BIOPSY SUPERFICIAL SVC007299 6000 6000 7800 9000 10200 11400

Orthopedics

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteBONE CURRETAGE - SMALL SVC007711 7700 10100 11600 13100 14700BONE GRAFTING SVC007312 22000 28600 33000 37400 41800BONE GRAFTING ONLY (IN NON UNION) SVC007609 27800 36200 41700 47300 52900BUDDY STRAPPING-STS SVC007610 800 800 1100 1200 1400 1600CALCENEUM / TALUS /TARSAL BONE-PLATE FIXATION SVC007461 21400 27900 32100 36400 40700CAST AE/AK (WITHOUT REDUCTION) SVC007612 3200 3200 4200 4800 5500 6100CAST BK/BE (WITH REDUCTION) (ORTHO) SVC007616 4100 4100 5400 6200 7000 7800CLAVICULAR BRACE APPLICATION SVC007219 1300 1300 1700 2000 2300 2500CLOSE REDUCTION OF FRACTURES SVC007300 20400 26600 30600 34700 38800CLOSED MANIPULATION OF SHOULDER DISLOCATION SVC007288 11400 14900 17100 19400 21700

CLOSED REDUCTION AND INTERNAL FIXATION OF TIBIA FRACTURE SVC007324 4400 5800 6600 7500 8400CLOSED REDUCTION OF FOREARM (COLLES) FRACTURE SVC007244 6500 8500 9800 11100 12400CLOSED REDUCTION OF METACARPAL FRACTURES AND PHALANGEAL FRACTURES SVC007247 9200 12000 13800 15700 17500CORE DECOMPRESSION SVC007142 16800 21900 25200 28600 32000CORRECTION OF TOE DEFORMITY SVC007325 7600 9900 11400 13000 14500CORRECTIVE OSTEOTOMY SVC007145 19100 24900 28700 32500 36300CORRECTIVE OSTEOTOMY (MINOR) SVC007713 7700 10100 11600 13100 14700CTE/CLUB FOOT MANIPULATIONS SVC007496 13900 18100 20900 23700 26500CURETTAGE SVC007562 9800 12800 14700 16700 18700DEBRIDEMENT - SMALL SVC007536 7700 7700 10100 11600 13100 14700DEBRIDEMENT AND SUTURING SVC007332 6900 6900 9000 10400 11800 13200DEEP DEBRIDEMENT AND SUTURING SVC007302 16500 21500 24800 28100 31400DIAGNOSTIC ARTHROSCOPY - SHOULDER SVC007593 17400 22700 26100 29600 33100DISARTICULATION - ELBOW/WRIST/ANKLE SVC007708 22900 29800 34400 39000 43600DISARTICULATION - SMALL JOINT SVC007709 12800 16700 19200 21800 24400DISCETOMY - MICRODISCECTOMY SVC007629 48200 62700 72300 82000 91600DISTAL RADIUS K-WIRE WITH EXTERNAL FIXATION -FOREARM SVC007630 8100 10600 12200 13800 15400DISTAL TIBIA & FABULA-EXTERNAL FIXATOR SVC007445 12300 16000 18500 21000 23400EPIDURA INJECTION / CAUDAL BLOCK SVC007632 11600 15100 17400 19800 22100EXCISION BURSA - KNEE JOINT /BAKERS CYST SVC007633 11000 14300 16500 18700 20900

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteEXCISION GANGLION SVC007538 3900 5100 5900 6700 7500EXCISION OF BONE TUMOURS SVC007729 36400 47400 54600 61900 69200EXCISION OF BONE TUMOURS - DEEP SVC007389 16800 21900 25200 28600 32000EXCISION OF CORN SVC007396 4600 6000 6900 7900 8800EXCISION OF RADIAL HEAD SVC007376 12800 16700 19200 21800 24400EXTERNAL FIXATION - PELVIS SVC007326 19100 24900 28700 32500 36300EXTERNAL FIXATOR (LARGE BONES) SVC007715 22900 29800 34400 39000 43600EXTERNAL FIXATOR WIRE (LLIZAROV) ADJUSTMENT SVC007634 3900 5100 5900 6700 7500FACETAL INJECTION - SPINE / EPIDURAL INJECTION (ORTHO) SVC007635 13000 16900 19500 22100 24700FASCIOTOMY - HAND/FEET SVC007712 8900 11600 13400 15200 17000FASCIOTOMY - LOWER LIMB SVC007636 13600 17700 20400 23200 25900FASCIOTOMY - UPPER LIMB SVC007637 12300 16000 18500 21000 23400FIXATION OF CARPAL FRACTURES SVC007353 16600 21600 24900 28300 31600FUNCTIONAL CAST BRACING SVC007156 6000 6000 7800 9000 10200 11400GANGLION - FOOT SVC007639 6600 8600 9900 11300 12600HALO/CX TRACTION/SKELETAL TRACTION APPLICATION SVC007724 11600 15100 17400 19800 22100HEMI ARTHROPLASTY/ BIPOLAR HIP/SHOULDER SVC007714 33600 43700 50400 57200 63900HEMIPELVECTOMY SVC007545 65700 85500 98600 111700 124900HIP SPICA SVC007162 6600 8600 9900 11300 12600HIP/ SHOULDER DISARTICULATION SVC007561 28000 36400 42000 47600 53200

ILIZAROV BONE TRANSPORT FOR GAP NON UNION - LONG BONE SVC007640 34700 45200 52100 59000 66000IMPLANT REMOVAL (K WIRES) SVC007531 2800 3700 4200 4800 5400IMPLANT REMOVAL NAILS AND PLATES SVC007163 2900 3800 4400 5000 5600IMPLANT REMOVAL WIRE AND SCREWS SVC007164 5000 6500 7500 8500 9500INGROWING TOE NAIL SVC007165 2800 3700 4200 4800 5400INGROWING TOE NAIL B/L SVC007408 4700 6200 7100 8000 9000INTERLOCK NAIL REMOVAL SVC007594 11000 14300 16500 18700 20900INTERLOCK NAILING - FEMUR / HUMERUS SVC007642 28700 37400 43100 48800 54600INTERLOCK NAILING - SC SVC007643 28700 37400 43100 48800 54600INTERLOCK NAILING- TIBIA/FIBULA SVC007644 28300 36800 42500 48200 53800INTERLOCKING NAIL TIBIA/ FEMUR SVC007492 28300 36800 42500 48200 53800

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteINTERNAL FIXATION OF SHAFT HUMERUS FRACTURE SVC007261 22800 29700 34200 38800 43400INTRAARTICULAR INJECTION SVC007166 2600 3400 3900 4500 5000INTRALESIONAL INJECTION FOR BONE SVC007529 2000 2600 3000 3400 3800JOINT REPLACEMENT(ARTHROPLASTY)-HAND SVC007292 33000 42900 49500 56100 62700K NAIL / V NAIL/ SQUARE NAIL REMOVAL SVC007645 7400 9700 11100 12600 14100K WIRE REMOVAL (OPD) > 2 SVC007595 1500 2000 2300 2600 2900K WIRE REMOVAL UNDER GA SVC007528 3900 5100 5900 6700 7500LARGE JOINT ARTHRODESIS SVC007168 29300 38100 44000 49900 55700LCS DECOMPRESSION & FUSION (>2 LEVELS) SVC007647 40800 53100 61200 69400 77600LIGAMENT RECONSTRUCTION SVC007596 12200 15900 18300 20800 23200LOOSE BODY REMOVAL SVC007369 19100 24900 28700 32500 36300LOOSE FOREIGN BODY REMOVAL - DEEP SVC007706 10200 13300 15300 17400 19400LOOSE FOREIGN BODY REMOVAL - SUPERFICIAL SVC007707 6400 8400 9600 10900 12200LUMBAR/CS DECOMPRESS FIXATION 1 LEVEL SVC007726 30400 39600 45600 51700 57800LUMBAR/CS DECOMPRESS FIXATION 2 LEVEL SVC007727 40300 52400 60500 68600 76600LUMBAR/CS DECOMPRESS FIXATION 3 LEVEL SVC007728 50200 65300 75300 85400 95400MAJOR TENDON TRANSFER SVC007539 31900 41500 47900 54300 60700MALLET FINGER REPAIR / FIXATION SVC007649 6600 8600 9900 11300 12600MALUNION CORRECTION WITH PLATE SVC007650 28700 37400 43100 48800 54600

MANIPULATION AND SKELETAL TRACTION FOR HIP DISLOCATION SVC007257 20000 26000 30000 34000 38000MCL RECONSTRUCTION PKG PKG007143 83800 109000 125700 142500 159300MENISCECTOMY SVC007266 21400 27900 32100 36400 40700MUA - FRACTURE ANKLE SVC007653 7400 9700 11100 12600 14100MUA - FRACTURE FEMUR IN CHILD SVC007654 11000 14300 16500 18700 20900MUA - SHOULDER / HUMERUS/ ANKLE / FOOT SVC007659 7400 9700 11100 12600 14100MUA & K-WIRE FIXATION - FOREARM / TIBIA / FIBULA SVC007656 13900 18100 20900 23700 26500MUA & PINNING - SHOULDER / HIP SVC007657 8100 10600 12200 13800 15400MUA FOREARAM / DISTAL RADIUS - EXTERNAL FIXTOR SVC007658 9800 12800 14700 16700 18700NAIL DYNAMIZATION -TIBIA/FIBULA/FEMUR/HUMERUS SVC007660 3900 5100 5900 6700 7500NAILING WITH BONE GRAFTING - NON UNION TIBIA SVC007661 25100 32700 37700 42700 47700NON UNION ORIF WITH BONE GRAFTING - CLAVICLE SVC007663 25100 32700 37700 42700 47700

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteNON UNION SHAFT - FEMUR / BOTH BONES FOREARM SVC007664 32300 42000 48500 55000 61400NON UNION SHAFT - HUMERUS SVC007665 32300 42000 48500 55000 61400

OLD NEGLECTED DISLOCATION SURGERY - ELBOW / SHOULDER / HIP SVC007666 28700 37400 43100 48800 54600OPEN BIOPSY (LARGE) SVC007350 17400 17400 22700 26100 29600 33100OPEN REDUCTION & INTERNAL FIXATION - COMPLEX SVC007379 18600 24200 27900 31700 35400OPEN REDUCTION & INTERNAL FIXATION (ORIF) FEMUR SVC007273 28000 36400 42000 47600 53200OPEN REDUCTION IN FRACTURE DISLOCATION- FOOT SVC007667 13900 18100 20900 23700 26500

OPEN REDUCTION INTERNAL FIXATION (ORIF) BOTH BONE FOREARM SVC007521 19100 24900 28700 32500 36300OPEN REDUCTION INTERNAL FIXATION CLAVICLE FRACTURE SVC007518 27500 35800 41300 46800 52300OPEN REDUCTION OF DISTAL RADIUS FRACTURE SVC007274 16600 21600 24900 28300 31600OPEN REDUCTION OF ELBOW FRACTURES SVC007275 46200 60100 69300 78600 87800OPEN REDUCTIONHIP SVC007554 21100 27500 31700 35900 40100OPEN SYNOVECTOMY SVC007178 16600 21600 24900 28300 31600ORIF - LATERAL MALLEOLUS / MEDIAL MALLEOLOUS SVC007668 13900 18100 20900 23700 26500ORIF - SHOULDER / UPPER END HUMERUS SVC007675 20800 27100 31200 35400 39600ORIF - SINGLE BONE - FOREARM SVC007670 12300 16000 18500 21000 23400ORIF - SUPRACONDYLAR - HUMERUS / INTERCONDYLAR HUMERUS -INTER SVC007672 21400 27900 32100 36400 40700ORIF PATELLA SVC007674 13900 18100 20900 23700 26500ORIF PELVIS AND ACETABULUM SVC007179 54900 71400 82400 93400 104400ORTHOPAEDIC WOUND DEBRIDEMENT - MEDIUM SVC007699 20500 26700 30800 34900 39000OSTEOTOMY - ANKLE SVC007676 13900 18100 20900 23700 26500OSTEOTOMY - TIBIA/FIBULA/HTO SVC007678 23500 30600 35300 40000 44700OSTEOTOMY METATARSAL / TARSAL - FOOT - MULTIPLE SVC007677 15500 20200 23300 26400 29500PATELLAR TENDON BEARING (PTB) CAST SVC007407 4200 4200 5500 6300 7200 8000PATELLECTOMY SVC007183 13900 18100 20900 23700 26500PCL RECONSTRUCTION PKG PKG007152 83800 109000 125700 142500 159300PERCUTANEOUS TENOTOMY - MULTIPLE SVC007339 4600 6000 6900 7900 8800PERCUTANEOUS TENOTOMY - SINGLE SVC007340 4600 6000 6900 7900 8800

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PERIARTICULAR FRACTURE KNEE (UPPER END TIBIA DISTAL FEMUR) SVC007679 25100 32700 37700 42700 47700PLASTER REMOVAL SVC007186 800 1100 1200 1400 1600PLIF - SPINE SVC007681 58700 76400 88100 99800 111600POP CAST ABOVE ELBOW SVC007398 3700 3700 4900 5600 6300 7100POP CAST ABOVE KNEE SVC007400 5500 5500 7200 8300 9400 10500POP CAST BELOW ELBOW SVC007397 2400 2400 3200 3600 4100 4600POP CAST BELOW KNEE SVC007399 2500 2500 3300 3800 4300 4800POP SLAB WITHOUT REDUCTION - AE /AK / CYLINDER SVC007682 1700 2300 2600 2900 3300POP SLAB WITHOUT REDUCTION - BEPOP SLAB WITHOUT REDUCTION - BE / BK SVC007684 1100 1500 1700 1900 2100POST.DECOMPRESSION SVC007489 28300 36800 42500 48200 53800POSTERIOR INSTRUMENTATION SVC007488 48900 63600 73400 83200 93000QUADRICEPS PLASTY SVC007556 15500 20200 23300 26400 29500RADIAL HEAD REPLACEMENT SVC007187 19100 24900 28700 32500 36300REMOVAL OF EXOSTOSIS - DEEP SVC007600 13900 18100 20900 23700 26500REMOVAL OF EXOSTOSIS - SUPERFICIAL SVC007601 6600 8600 9900 11300 12600REMOVAL OF LARGE IMPLANTS SVC007380 19100 24900 28700 32500 36300REPAIR OF QUADRICEPS OR PATELLAR TENDON SVC007685 12300 16000 18500 21000 23400RF. LESION FOR FACET JOINT PAIN SYNDROME SVC007725 20600 26800 30900 35100 39200RJ BADAGE / STRAPPING SVC007688 1400 1900 2100 2400 2700

ROTATOR CUFF REPAIR - SHOULDER (ARTHROSCOPIC/MINI OPEN) SVC007689 40100 52200 60200 68200 76200SCOTCH CAST REMOVAL SVC007406 1400 1400 1900 2100 2400 2700SEQUES TRECTOMY SVC007568 22000 28600 33000 37400 41800SEQUESTRECTOM + CURETTAGE LOWER LIMB BONE SVC007482 21400 27900 32100 36400 40700SEQUESTRECTOM + CURETTAGE UPPER LIMB BONE SVC007460 15100 19700 22700 25700 28700SINGLE-EVENT MULTILEVEL SURGERY (SEMLS) LARGE SVC007722 51400 66900 77100 87400 97700SINGLE-EVENT MULTILEVEL SURGERY (SEMLS) MEDIUM SVC007721 33000 42900 49500 56100 62700SINGLE-EVENT MULTILEVEL SURGERY (SEMLS) SMALL SVC007723 20800 27100 31200 35400 39600SKELETAL TRACTION SVC007195 4600 6000 6900 7900 8800SKIN TRACTION SVC007336 600 800 900 1100 1200

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteSMALL JOINT REPLACEMENTS SVC007363 20800 27100 31200 35400 39600SOFT TISSUE OPERATIONS FOR C.T.E.V. SVC007383 17400 22700 26100 29600 33100SOFT TISSUE RELEASE SVC007334 15500 20200 23300 26400 29500SPINAL FRACTURE - PSTERIOR FIXATION WITH FUSION SVC007691 48900 63600 73400 83200 93000SPINAL OPERATION (LAMINECTOMY+DISCECTOMY) SVC007381 61000 79300 91500 103700 115900SPINE-VERTEBROPLASTY (EACH LEVEL) SVC007459 28300 36800 42500 48200 53800STRAPPING SVC007197 700 1000 1100 1200 1400SUBACROMIAL DECOMPRESSION SVC007198 20800 27100 31200 35400 39600SUPERFICIAL DEBRIDEMENT AND SUTURING SVC007303 8200 8200 10700 12300 14000 15600SUPRACONDYLAR FEMORAL OSTEOTOMY FIXATION SVC007692 25100 32700 37700 42700 47700SUPRACONDYLAR FRACTURE - MUA & WIRE- HUMERUS SVC007693 12300 16000 18500 21000 23400SURGICAL MANAGEMENT OF SCAPHOID FRACTURES SVC007313 16600 21600 24900 28300 31600SUTURING - INTERMEDIATE SVC007374 1400 1400 1900 2100 2400 2700SUTURING - MAJOR SVC007375 1900 1900 2500 2900 3300 3700SUTURING - MINOR SVC007373 800 800 1100 1200 1400 1600SYNOVECTOMY - ELBOW SVC007598 15500 20200 23300 26400 29500SYNOVECTOMY - WRIST / ANKLE SVC007599 13900 18100 20900 23700 26500SYNOVIAL BIOPSY SVC007289 7200 7200 9400 10800 12300 13700TENDOACHILLES REPAIR SVC007200 12300 16000 18500 21000 23400TENDON REPAIR - SINGLE SVC007541 27300 35500 41000 46500 51900TENDON REPAIR SINGLE SVC007204 9800 12800 14700 16700 18700TENSION BAND & OTHER FORM & PATELLAR RECONSTRUCTION OR OLECRANON FRACTURES SVC007384 22000 28600 33000 37400 41800TENSION BAND WIRING SVC007377 8100 10600 12200 13800 15400THROCHANTERIC/ SUBTHROCHANTERIC FRACTURE FEMUR (DSH/DCH/PFN) SVC007491 38300 49800 57500 65200 72800TIBIA FRACTURE PROXIMAL/ MIDDLE/ DISTAL - ORIF/ CRIF WITH NAILING/ LOCKING SVC007517 31100 40500 46700 52900 59100TORTICOLLIS MONOPOLAR RELEASE SVC007571 13900 18100 20900 23700 26500TOTAL HIP REPLACEMENT PKG PKG003071 177900 231300 266900 302500 338100TOTAL HIP REPLACEMENT-B/L PKG PKG007185 242600 315400 363900 412500 461000TOTAL KNEE REPLACEMENT (B/L) - A PKG PKG004397 225300 292900 338000 383100 428100

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteTOTAL KNEE REPLACEMENT (U/L) - A PKG PKG004417 184800 240300 277200 314200 351200TOTAL SHOULDER REPLACEMENT SVC007211 40800 53100 61200 69400 77600TRANS ARTICULAR FIXATION SVC007710 16100 21000 24200 27400 30600TRIGGER FINGER RELEASE SVC007542 7600 9900 11400 13000 14500TRIPLE ARTHRODESIS SVC007212 21000 27300 31500 35700 39900TUMOUR RESECTION & GRAFT - OTHER SITES (LARGE) SVC007696 35900 46700 53900 61100 68300UL/LL ACUTE OSTEOMYLITUS SURG - DECOMPRESSION SVC007697 13900 18100 20900 23700 26500UNICONDYLAR KNEE REPLACEMENT SVC007213 34400 44800 51600 58500 65400VASCULARISED FIBULA GRAFTING FOR BONE DEFECTS SVC007549 35900 46700 53900 61100 68300

FASTRACH SVC013858 4400 5800 6600 7500 8400HAIR REDUCTION-CHIN_GST SVC001570 39500 45570 51650 54690 57730LITHIUM LUMINOUS LASER CHARGES LEVEL -1(UROLOGY) SVC010828 5300 6900 8000 9100 10100LITHIUM LUMINOUS LASER CHARGES LEVEL -2(UROLOGY) SVC010829 7900 10300 11900 13500 15100MICRONEEDLING FOR HYPERPIGMENTATION_GST SVC001365 4400 5800 6600 7500 8400MICRONEEDLING FOR PRP_GST SVC001364 28900 37600 43400 49200 55000Mucormycosis Debridment SVC013535 42000 54600 63000 71400 79800PROSEAL SIZE 3 SVC013859 1400 1900 2100 2400 2700PROSEAL SIZE 4 SVC013860 1400 1900 2100 2400 2700THORACOSCOPIC PERICARDIAL WINDOW SVC010653 31100 40500 46700 52900 59100

ADVANCED REHAB SESSION UPTO 60 MINUTES SVC008092 1800 1800 2400 2700 3100 3500CARDIAC REHABILITATION SVC008095 650 850 980 1110 1170 1240CARDIAC REHABILITATION (36 SESSIONS)_PKG PKG016345 20800 20800 27100 31200 35400 39600CHEST PHYSIOTHERAPY (CPT) SVC008019 250 330 380 430 450 480CHEST PHYSIOTHERAPY + ROM EXERCISES SVC008020 340 450 510 580 620 650Comprehensive Neuro Rehabilitation Package 10 visits SVC013604 28350 36860 42530 48200 51030 53870Comprehensive Neuro Rehabilitation Upto 120 Minutes SVC013603 3150 4100 4730 5360 5670 5990CONTINUOUS PASSIVE MOVEMENT (CPM) SVC008021 340 450 510 580 620 650CRYO THERAPY SVC008022 280 370 420 480 510 540DEEP TISSUE RELEASE (DTR) SVC008040 250 330 380 430 450 480DOUBLE THERAPY ( ELECTROTHERAPY AND EXCERCISE ) SVC008068 960 1250 1440 1640 1730 1830

Others

Physiotherapy

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteELECTRICAL MUSCLE STIMULATION (EMS) SVC008023 310 410 470 530 560 590EXERCISE & MODALITIES SVC008018 310 410 470 530 560 590EXERCISE & MODALITIES - 2 SVC008061 310 410 470 530 560 590EXERCISE TESTING (FUNCTIONAL TESTING) SVC008094 1040 1360 1560 1770 1880 1980EXERCISE TESTING (VO2 MAX AND FUNCTIONAL TEST) SVC008093 1740 2270 2610 2960 3140 3310FALLS PREVENTION AND JOINT PROTECTION SVC008041 280 370 420 480 510 540GAIT TRAINING SVC008024 280 370 420 480 510 540INFRA RED RAYS THERAPY (IRR) SVC008025 210 280 320 360 380 400INPATIENT PHYSIOTHERAPY UPTO 20 MINUTES SVC008089 580 760 870 990 1050 1110INTERFERENTIAL THERAPY (IFT) SVC008026 300 390 450 510 540 570INTRA MUSCULAR STIMULATION SVC008059 1400 1400 1900 2100 2400 2700KINESIOTAPING (KT) ANKLE SVC008042 1040 1360 1560 1770 1880 1980KINESIOTAPING (KT) KNEE SVC008043 1040 1360 1560 1770 1880 1980KINESIOTAPING (KT) NECK SVC008044 1040 1360 1560 1770 1880 1980KINESIOTAPING (KT) SHOULDER SVC008045 1040 1360 1560 1770 1880 1980KINESIOTAPING (KT) SPINE SVC008046 1040 1360 1560 1770 1880 1980LASER THERAPY SVC008027 350 460 530 600 630 670MOIST HEAT THERAPY SVC008028 280 370 420 480 510 540MRP SVC008047 250 330 380 430 450 480MYOFASCIAL RELEASE (MFR) SVC008048 250 330 380 430 450 480MYOTHERAPY SVC008049 250 330 380 430 450 480NEURAL MOBILIZATION SVC008050 250 330 380 430 450 480NEURO REHABILATATION SVC008064 1100 1100 1500 1700 1900 2100NEURO REHABILITATION SVC008029 930 1210 1400 1590 1680 1770NEURO REHABILITATION (24 SESSIONS)_PKG PKG016347 19900 19900 25900 29900 33900 37900NEURO REHABILITATION FOR CEREBRAL PALSY SVC008051 280 370 420 480 510 540NEUROREHABILITATION (ADULT) PACKAGE SVC008052 730 950 1100 1250 1320 1390ORTHOPEDIC REHABILITATIO(10 VISITS) PKG PKG016348 8000 8000 10400 12000 13600 15200ORTHOPEDIC REHABILITATIO(20 VISITS) PKG PKG016349 16700 16700 21800 25100 28400 31800ORTHOPEDIC REHABILITATION SVC008063 1040 1360 1560 1770 1880 1980PAIN MANAGEMENT SVC008053 760 990 1140 1300 1370 1450Physio Home Visit Plan A SVC013595 840 1100 1260 1430 1520 1600

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuitePhysio Home Visit Plan A Package 10 Visits SVC013599 7560 9830 11340 12860 13610 14370Physio Home Visit Plan B SVC013596 1260 1640 1890 2150 2270 2400Physio Home Visit Plan B Package 10 visits SVC013600 11340 14750 17010 19280 20420 21550Physio Home Visit Plan C SVC013597 1580 2060 2370 2690 2850 3010Physio Home Visit Plan C Package 10 visits SVC013601 14180 18440 21270 24110 25530 26950Physio Home Visit Plan D SVC013598 1890 2460 2840 3220 3410 3600Physio Home Visit Plan D Package 10 visits SVC013602 17010 22120 25520 28920 30620 32320PHYSIO PACKAGE FOR ITU/ICU PATIENTS SVC008054 560 730 840 960 1010 1070PHYSIO PACKAGE FOR WARD PATIENTS SVC008055 450 590 680 770 810 860PHYSIO-HOME VISIT SVC008100 1390 1390 1810 2080 2360 2640PHYSIO-HOME VISIT-10 VISITS SVC008101 12710 12710 16520 19060 21600 24140PHYSIOTHERAPY CONSULTATION SVC008102 900 900 900 900 900 900PHYSIOTHERAPY REHABILITATION PROGRAM SVC008060 700 910 1050 1190 1260 1330PHYSIOTHERAPY UPTO 40 MINUTES SVC008090 1040 1360 1560 1770 1880 1980PHYSIOTHERAPY UPTO 60 MINUTES (HANDS ON) SVC008091 1390 1810 2090 2370 2510 2650PNF SVC008056 250 330 380 430 450 480POSTURAL AWARENESS THERAPY SVC008030 280 370 420 480 510 540PRE & POST NATAL EXERCISES SVC008031 450 590 680 770 810 860PULMONARY FUNCTION TEST / LUNG FUNCTION TEST SVC008057 1260 1640 1890 2150 2270 2400PULMONARY REHABILITATION SVC008096 650 850 980 1110 1170 1240PULMONARY REHABILITATION (30 SESSION)_PKG PKG016346 20800 20800 27100 31200 35400 39600Rehab Home Visit - Chief Physiotherapist SVC013607 5250 6830 7880 8930 9450 9980SENIOR CITIZEN FITNESS PROGRAM(25 VISITS) SVC008098 11550 15020 17330 19640 20790 21950

SENIOR CITIZEN FITNESS PROGRAM(GROUP SESSION FOR 25 DAYS) SVC008099 2890 3760 4340 4920 5210 5500SHORT WAVE DIATHERMY (SWD) SVC008032 300 390 450 510 540 570SUSPENSION THERAPY SVC008033 280 370 420 480 510 540Swallowing Therapy Package SVC013606 8510 11070 12770 14470 15320 16170TILT TABLE THERAPY SVC008034 280 370 420 480 510 540TRACTION (CERVICAL/ LUMBAR) SVC008035 330 430 500 570 600 630TRANSCUTANEOUS NERVE STIMULATION (TENS) SVC008036 300 390 450 510 540 570ULTRA SOUND THERAPY (UST) SVC008037 260 340 390 450 470 500

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteULTRA VIOLET THERAPY (UVR) SVC008038 280 370 420 480 510 540VESTIBULAR REHABILITATION SVC008058 270 360 410 460 490 520VOICE SWALLOW ASSESSMENT SVC000781 700 700 1000 1100 1200 1400VOICE SWALLOW THERAPY SVC000785 700 700 1000 1100 1200 1400WAX THERAPY SVC008039 350 460 530 600 630 670Swallowing Assessment and Therapy SVC013605 900 1350 1350 1350 1350 1350

TRACHEAL RECONSTRUCTIONS SVC010641 32300 42000 48500 55000 61400Brachiobasilic Fistula With Transposition SVC013999 40000 52000 60000 68000 76000A V FISTULA REPAIR SVC013808 15800 20600 23700 26900 30100ABDOMINAL- LIPOSUCTION SVC008182 42800 55700 64200 72800 81400BAGGY EYELIDS(BLEPHAROPLASTY )PER EYE SVC008130 23100 30100 34700 39300 43900CHIN AUGMENTATION SVC008132 33900 44100 50900 57700 64500COSMETIC CORRECTION OF DEFORMITIES OF LIP SVC008135 18500 24100 27800 31500 35200DERMABRASION - PART OF FACE SVC008138 18500 24100 27800 31500 35200DERMAL FAT GRAFTING SVC008137 17400 22700 26100 29600 33100DRAINAGE OF ABCESS SVC008193 17600 22900 26400 30000 33500EXCISION OF CARBUNCLE SVC008141 9800 12800 14700 16700 18700EXCISION OF HAEMANGIOMA (LARGE) SVC008171 42300 55000 63500 72000 80400FACIAL PARALYSIS - SLING SVC008142 27400 35700 41100 46600 52100FASCIOCUTANEOUS FLAP LARGE SVC008187 77400 100700 116100 131600 147100FASCIOCUTANEOUS FLAP SMALL SVC008188 11600 15100 17400 19800 22100FINGER TIP INJURY - FLAP SVC008144 72800 94700 109200 123800 138400FINGER TIP INJURY - REPAIR AND GRAFT SVC008145 24300 31600 36500 41400 46200FORE - HEAD RHINOPLASTY SVC008146 33200 43200 49800 56500 63100FREE GRAFTS - VERY LARGE AREA 20% AND ABOVE SVC008183 38200 49700 57300 65000 72600FULL THICKNESS GRAFT - LARGE SVC011909 23100 30100 34700 39300 43900FULL THICKNESS GRAFT - MEDIUM SVC011908 15400 20100 23100 26200 29300FULL THICKNESS GRAFT - SMALL SVC011907 7700 10100 11600 13100 14700INTERNAL JUGULAR VEIN GRAFT SVC011729 15800 20600 23700 26900 30100LACERATIONS (FACE) REPAIR- MODERATE SVC008176 10000 13000 15000 17000 19000LIPECTOMY - COSMETIC SVC008148 28900 37600 43400 49200 55000

Plastic Surgery

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LIPOSUCTION- BREAST REDUCTION MAMMOPLASTY-UNILERTERL SVC008181 39300 51100 59000 66900 74700MAJOR VASCULAR SURGERY SVC011924 38200 49700 57300 65000 72600MANAGEMENT OF CLOSED FRACTURE- NOSE SVC008133 12800 16700 19200 21800 24400MANDIBLE FRACTURE - CLOSED REDUCTION SVC008151 25300 32900 38000 43100 48100MANDIBLE FRACTURE - OPEN REDUCTION & PLATING SVC008152 34700 45200 52100 59000 66000MAXILLARY FRACTURE (CMF SUSPENSION AND PLATING) SVC008155 28900 37600 43400 49200 55000MULTIPLE LACERATIONS (FACE) REPAIR SVC008170 13200 17200 19800 22500 25100OPEN REDUCTION INTERNAL FIXATION FRACTURE ZYGOMA SVC008156 17400 22700 26100 29600 33100OPEN REDUCTION OF MALAR FRACTURE SVC008150 28900 37600 43400 49200 55000PALATAL FISTULA CLOSURE WITH TONGUE FLAP SVC011925 27200 35400 40800 46300 51700PTOSIS-ERONTALIS SLING PROCEDURE (BILATERAL) SVC008158 30300 39400 45500 51600 57600PTOSIS-FRONTALIS SLING PROCEDURE (UNILATERAL) SVC008159 20700 27000 31100 35200 39400RELEASE OF DUPUYTREN'S CONTRACTURE SVC008139 8600 11200 12900 14700 16400REMOVAL OF MANDIBLE PLATE SVC008153 20800 27100 31200 35400 39600REPAIR OF TORN EAR LOBULE SVC008157 7000 9100 10500 11900 13300REVASCULARISATION OF LIMB SVC008163 80600 104800 120900 137100 153200RHINOPLASTY-COSMETIC SVC008164 28900 37600 43400 49200 55000SCAR REVISION-LARGE SVC008185 19700 25700 29600 33500 37500SCAR REVISION-SMALL SVC008184 13900 18100 20900 23700 26500SKIN GRAFTING - LARGE (GREATER THAN 20% OF TOTAL BOBY SURFACE AREA) SVC008165 25500 33200 38300 43400 48500

SKIN GRAFTING - MEDIUM (8-20% OF TOTAL BOBY SURFACE AREA) SVC008166 19700 25700 29600 33500 37500SKIN GRAFTING - SMALL (LESS THAN 8% OF TOTAL BODY SURFACE AREA) SVC008167 9900 12900 14900 16900 18900TRANSPOSITION OF THE BASILIC VEIN FOR AV FISTULA SVC010893 63000 81900 94500 107100 119700Z-PLASTY SVC008204 15400 20100 23100 26200 29300

RIGID BRONCHOSCOPY SVC010637 16500 21500 24800 28100 314006 MIN WALK TEST SVC008248 300 300 400 500 600 600ASTHAMA EDUCATION SVC008251 400 400 600 600 700 800

Pulmonology

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteBALLOON BRONCHOPLASTY SVC008278 2600 2600 3400 3900 4500 5000BRONCHOSCOPIC INTUBATION SVC008295 3200 3200 4200 4800 5500 6100BRONCHOSCOPIC SCREENING SVC008288 2600 2600 3400 3900 4500 5000

BRONCHOSCOPY WITH APC/ELECTROCAUTERY (FOR HAEMOPTYSIS) SVC008292 18300 23800 27500 31200 34800BRONCHOSCOPY WITH BIOPSY SVC008229 8100 8100 10600 12200 13800 15400

BRONCHOSCOPY WITH TRANS BRONCHIAL NEEDLE ASPIRATION (TBNA) SVC008230 13600 17700 20400 23200 25900BRUSHINGS SVC008269 900 900 1200 1400 1600 1800CONVEX PROBE- ENDOBRONCHIAL ULTRASOUND (DIAGNOSTIC) CP-EBUS SVC008271 33400 43500 50100 56800 63500

CONVEX PROBE- ENDOBRONCHIAL ULTRASOUND (DIAGNOSTIC) CP-EBUS+VIDEO BRONCHOSCOPE+ENDOBRONCHIAL BIOPSY( PKG007444 34700 34700 45200 52100 59000 66000

CONVEX PROBE-ENDOBRONCHIAL ULTRASOUND (STAGING) CP-EBUS SVC008272 25500 33200 38300 43400 48500CPAP USAGE REPORT SVC008256 600 600 800 900 1100 1200EBUS SCREENING SVC008309 10400 13600 15600 17700 19800EBUS-TBNA CHARGES SVC008249 21300 27700 32000 36300 40500

ENDOBRONCHIAL BIOPSY(EBB)/TRANSBRONCHIAL BIOPSY(TBB) SVC008270 2800 2800 3700 4200 4800 5400ENDOBRONCHIAL NEEDLE ASPIRATION (EBNA) / TRANSBRONCHIAL NEEDLE ASPIRATION(TBNA) SVC008283 3300 3300 4300 5000 5700 6300ESOPHAGEAL DOPPLER SVC008247 3500 3500 4600 5300 6000 6700FENOMETRY SVC008289 800 800 1100 1200 1400 1600FIBEROPTIC BRONCHOSCOPY + BALOON DILATATION SVC008240 17700 23100 26600 30100 33700FIBEROPTIC BRONCHOSCOPY + ENDOBRONCHIAL BIOPSY SVC008235 6900 6900 9000 10400 11800 13200FIBRE OPTIC BRONCHOSCOPY SVC008225 9800 9800 12800 14700 16700 18700FIBREOPTIC BRONCHOSCOPIC INTUBATION SVC008232 6800 6800 8900 10200 11600 13000FOB- BRONCHOPLEURAL FISTULA (BPF) CLOSURE (GLUE INSERTION/SPIGOT) SVC008276 3900 3900 5100 5900 6700 7500FOB FOREIGN BODY REMOVAL SVC008284 5100 5100 6700 7700 8700 9700

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FOB RECANALIZATION (CRYORECANALIZATION/ELECTROCAUTERY/APC) SVC008274 10200 13300 15300 17400 19400INDWELLING PLEURAL CATHETER (IPC) INSERTION SVC008282 10200 13300 15300 17400 19400MINI BAL (NON-BRONCHIAL LAVAGE) SVC008296 1400 1400 1900 2100 2400 2700MULTIPLE SLEEP LATENCY TEST SVC008304 11600 15100 17400 19800 22100PFT WITH FRC SVC008266 300 300 400 500 600 600PFT WITH REVERSIBILITY SVC008306 3000 3000 3900 4500 5100 5700PHLEBOTOMY SVC008259 1800 1800 2400 2700 3100 3500PLEURAL BIOPSY SVC008260 6500 6500 8500 9800 11100 12400PLEURODESIS_PULMONOLOGY SVC008287 3900 3900 5100 5900 6700 7500PULMONARY FUNCTION TEST SVC008226 2100 2100 2800 3200 3600 4000RADIAL PROBE-ENDOBRONCHIAL ULTRASOUND (RP-EBUS) SVC008273 15300 19900 23000 26100 29100RB STENT PLACEMENT (TRACHEAL/BRONCHIAL) SVC008285 6400 6400 8400 9600 10900 12200

RIGHT HEART CATHETERIZATION AND HEMODYNAMIC STUDY FOR PAH SVC008246 26700 34800 40100 45400 50800RIGID BRONCHOSCOPY + ENDOBRONCHIAL BIOPSY SVC008241 18100 18100 23600 27200 30800 34400RIGID BRONCHOSCOPY + FOREIGN BODY REMOVAL SVC008242 23800 31000 35700 40500 45300RIGID BRONCHOSCOPY + STENT PLACEMENT SVC008244 26500 34500 39800 45100 50400RIGID BRONCHOSCOPY + TUMOUR DEBULKING (LASER) SVC008243 26500 34500 39800 45100 50400RIGID THORACOSCOPY SVC008245 18100 23600 27200 30800 34400SELF EXPANDING METALLIC STENT (SEMS) INSERTION SVC008277 10200 13300 15300 17400 19400SEMI-RIGID PLEUROSCOPY SVC008281 15300 19900 23000 26100 29100SLEEP STUDY SVC008261 23700 30900 35600 40300 45100SLEEP STUDY (POLYSOMNOGRAPHY WITH TITRATION) SVC008303 21000 27300 31500 35700 39900SLEEP STUDY (POLYSOMNOGRAPHY) SVC008228 13600 17700 20400 23200 25900SLEEP STUDY (PULSE OXIMETRY) SVC008305 7000 7000 9100 10500 11900 13300SPIROMETRY SVC008267 1100 1100 1500 1700 1900 2100SPIROMETRY WITH DIFFUSION STUDIES SVC008227 3100 3100 4100 4700 5300 5900SPUTUM INDUCTION/ULTRASONIC NEBULIZERS SVC008299 300 300 400 500 600 600STREPTOKINASE INSTILLATION IN PLEURAL CAVITY SVC008308 2100 2100 2800 3200 3600 4000THERAPEUTIC LAVAGE (SINGLE LUNG) SVC008275 8400 8400 11000 12600 14300 16000USG GUIDED MASS LESION BIOPSY SVC008262 8700 8700 11400 13100 14800 16600

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteVIDEO BRONCHOSCOPE SVC008265 10100 13200 15200 17200 19200WASHINGS/BRONCHOALVEOLAR LAVAGE (BAL) SVC008268 900 900 1200 1400 1600 1800

AV FISTULA MAPPING(PKG) PKG021371 5300 5300 6900 8000 9100 10100BIOPHYSICAL PROFILE(BPP) SVC009172 1840 2400 2760 3130 3320 3500BONE DENSITOMETRY - BOTH SITES SVC009188 2650 3450 3980 4510 4770 5040BONE DENSITOMETRY - BOTH SITES (SPINE, HIP & EXTREMITY) SVC009189 3310 4310 4970 5630 5960 6290BONE DENSITOMETRY - SINGLE SITE SVC009187 3060 3980 4590 5210 5510 5820BONE DENSITOMETRY LUMBAR SPINE AP SVC009221 1330 1730 2000 2270 2400 2530BONE DENSITOMETRY LUMBAR SPINE AP & FEMUR SVC009222 3020 3930 4530 5140 5440 5740BONE DENSITOMETRY SINGLE FEMUR SVC009219 1330 1730 2000 2270 2400 2530

BONE DENSITOMETRY SINGLE FEMUR WITH FRACTURE RISK ESTIMATE SVC009220 1330 1730 2000 2270 2400 2530BONE DENSITOMETRY- WHOLE BODY SVC009190 3750 4880 5630 6380 6750 7130BONE DENSITOMETRY WHOLE BODY FAT FRACTION SVC009223 4570 5950 6860 7770 8230 8690BRONCHIAL BRUSH SMEAR FOR CYTOLOGY SVC009135 5370 6990 8060 9130 9670 10210CAPD CATHETER REMOVAL SVC009136 5270 6860 7910 8960 9490 10020CARDIAC COMPUTED TOMOGRAPHY FOR CALCIUM SCORING (IMAGING) SVC009657 2210 2880 3320 3760 3980 4200CARDIOTOCOGRAPHY SVC009137 590 770 890 1010 1070 1130CD CHARGES SVC009193 320 420 480 550 580 610CHEMOEMBOLISATION SVC009023 28800 28800 37500 43200 49000 54800COLONOSCOPY WITH BIOPSY SVC009138 38300 38300 49800 57500 65200 72800CT DBS PROTOCOL SVC011826 3310 4310 4970 5630 5960 6290CT DBS PROTOCOL WITH CONTRAST SVC011827 5520 7180 8280 9390 9940 10490CT 3D RECONSTRUCTION SVC009701 1660 2160 2490 2830 2990 3160CT ABDOMEN & PELVIS CONTRAST SVC008668 8820 11470 13230 15000 15880 16760CT ABDOMEN & PELVIS PLAIN SVC008669 6620 8610 9930 11260 11920 12580CT ABDOMEN CONTRAST SVC008317 8400 10920 12600 14280 15120 15960CT ABDOMEN LOWER CONTRAST SVC009045 6620 8610 9930 11260 11920 12580CT ABDOMEN LOWER PLAIN SVC009184 4410 5740 6620 7500 7940 8380CT ABDOMEN PLAIN SVC008318 6300 8190 9450 10710 11340 11970

Radiology

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteCT ABDOMEN UPPER PLAIN SVC008319 5670 7380 8510 9640 10210 10780CT ABDOMEN WITH CONTRAST SVC009107 8820 11470 13230 15000 15880 16760CT ANGIOGRAPHY ABDOMEN SVC008321 13230 17200 19850 22500 23820 25140CT ANGIOGRAPHY BRAIN (CEREBRAL ANGIOGRAPHY) SVC008670 6620 8610 9930 11260 11920 12580CT ANGIOGRAPHY CHEST SVC008324 11030 14340 16550 18760 19860 20960CT ANGIOGRAPHY CHEST & ABDOMEN SVC008671 13230 17200 19850 22500 23820 25140CT ANGIOGRAPHY CORONARY 128 SLICE SVC009334 14140 18390 21210 24040 25460 26870

CT ANGIOGRAPHY CORONARY 128 SLICE + PULMONARY + AORTA SVC009336 17640 22940 26460 29990 31760 33520CT ANGIOGRAPHY HEAD & NECK(PKG) PKG021329 12600 12600 16400 18900 21500 24000CT ANGIOGRAPHY HEPATIC SVC008674 12600 16380 18900 21420 22680 23940CT ANGIOGRAPHY LIVER DONOR(PKG) PKG010379 18300 18300 23800 27500 31200 34800CT ANGIOGRAPHY LOWER LIMBS SVC008322 13230 17200 19850 22500 23820 25140CT ANGIOGRAPHY OF CERVICAL & INTRACRANIAL VESSELS SVC008675 11030 14340 16550 18760 19860 20960CT ANGIOGRAPHY OF NECK VESSELS SVC008325 9330 12130 14000 15870 16800 17730CT ANGIOGRAPHY PERIPHERAL SVC008676 13230 17200 19850 22500 23820 25140CT ANGIOGRAPHY PULMONARY SVC008326 9270 12060 13910 15760 16690 17620CT ANGIOGRAPHY RENAL SVC008327 9330 12130 14000 15870 16800 17730CT ANGIOGRAPHY UPPER LIMB SVC008328 13230 17200 19850 22500 23820 25140CT ANKLE WITH FOOT SVC008677 4410 5740 6620 7500 7940 8380CT AORTAGRAM SVC008329 12600 16380 18900 21420 22680 23940CT BRAIN & ORBIT CONTRAST SVC008678 6620 8610 9930 11260 11920 12580CT BRAIN & PNS CONTRAST SVC008679 6620 8610 9930 11260 11920 12580CT BRAIN & PNS PLAIN SVC008680 4410 5740 6620 7500 7940 8380CT BRAIN PERFUSION ANGIOGRAPHY SVC008681 13230 17200 19850 22500 23820 25140CT BRAIN PITUITARY SVC008682 3310 4310 4970 5630 5960 6290CT BRAIN PLAIN SVC008646 3150 4100 4730 5360 5670 5990CT BRAIN WITH CONTRAST SVC008330 4970 6470 7460 8450 8950 9450CT BRONCHOSCOPY SVC009387 8670 11280 13010 14740 15610 16480CT CARDIAC PEDIATRIC SVC008684 11030 14340 16550 18760 19860 20960CT CD CHARGES SVC009016 400 400 600 600 700 800CT CEREBRAL VENOGRAM CONTRAST SVC008685 8820 11470 13230 15000 15880 16760

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteCT CERVICAL SPINE SVC008331 5040 6560 7560 8570 9080 9580CT CERVICAL SPINE FLEXION EXTENSION SVC008686 6620 8610 9930 11260 11920 12580CT CERVICAL SPINE WITH CONTRAST SVC008332 7500 9750 11250 12750 13500 14250CT CERVICO DORSAL SPINE SVC008687 6620 8610 9930 11260 11920 12580CT CHEST SVC008333 5040 6560 7560 8570 9080 9580CT CHEST & ABDOMEN WITH CONRAST (PKG) PKG021366 18900 18900 24600 28400 32200 36000CT CHEST CONTRAST SVC008334 7140 9290 10710 12140 12860 13570CT CISTERNOGRAPHY SVC008689 11030 14340 16550 18760 19860 20960CT CONTRAST CHARGES - 100 ML SVC008335 2210 2880 3320 3760 3980 4200CT CONTRAST CHARGES - 50 ML SVC008337 1110 1450 1670 1890 2000 2110CT CONTRAST TOPUP PACKAGE SVC009227 4340 5650 6510 7380 7820 8250CT CV JUNCTION SVC008339 5300 6890 7950 9010 9540 10070CT DENTAL - MANDIBLE SVC009390 6930 9010 10400 11790 12480 13170CT DENTAL - MAXILLA SVC009391 6930 9010 10400 11790 12480 13170CT DIAGNOSTIC ASPIRATION SVC008691 5520 7180 8280 9390 9940 10490CT DORSAL LUMBAR SPINE SVC008341 6620 8610 9930 11260 11920 12580CT DORSAL SPINE SVC008342 5300 6890 7950 9010 9540 10070CT DORSAL SPINE WITH CONTRAST SVC008343 7500 9750 11250 12750 13500 14250CT DOUBLE RULE OUT (CORONARY+AORTA) SVC008672 15440 20080 23160 26250 27800 29340CT DVD CHARGES SVC011930 370 370 370 370 370 370CT ELBOW BOTH SVC008692 4410 5740 6620 7500 7940 8380CT ELBOW LEFT SVC008693 4410 5740 6620 7500 7940 8380CT ELBOW RIGHT SVC008694 4410 5740 6620 7500 7940 8380CT ENTEROGRAPHY SVC009696 8820 11470 13230 15000 15880 16760CT FACE SVC008344 5300 6890 7950 9010 9540 10070CT FACE LOWER PLAIN SVC008695 3310 4310 4970 5630 5960 6290CT FACE WITH CONTRAST SVC008345 7500 9750 11250 12750 13500 14250CT FACIAL BONES PLAIN SVC008696 4410 5740 6620 7500 7940 8380CT FEMUR LEFT PLAIN SVC009765 4410 5740 6620 7500 7940 8380CT FEMUR RIGHT PLAIN SVC008698 4410 5740 6620 7500 7940 8380CT FILM SVC009017 320 420 480 550 580 610CT GUIDANCE SVC013519 7350 9560 11030 12500 13230 13970

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteCT GUIDANCE TUMOR MARKING SVC013520 7350 9560 11030 12500 13230 13970CT GUIDANCE TUMOR MARKING (SHORT) SVC013521 5250 6830 7880 8930 9450 9980CT GUIDANCE( SHORT) SVC013522 5250 6830 7880 8930 9450 9980CT GUIDED ABSCESS DRAINAGE SVC009260 8090 10520 12140 13760 14570 15380CT GUIDED BIOPSY SVC009020 7720 10040 11580 13130 13900 14670CT GUIDED BONE BIOPSY SVC009293 8820 11470 13230 15000 15880 16760CT GUIDED CATHETER DRAINAGE SVC009241 7720 10040 11580 13130 13900 14670CT GUIDED FNAC SVC008347 6930 9010 10400 11790 12480 13170CT GUIDED NERVE BLOCK SVC009238 7720 10040 11580 13130 13900 14670CT GUIDED NEURO NAVIGATION PLAIN STUDY SVC009246 3310 4310 4970 5630 5960 6290CT GUIDED NEURO NAVIGATION WITH CONTRAST STUDY SVC009247 5520 7180 8280 9390 9940 10490CT GUIDED PERCUTANEOUS NEPHROSTOMY SVC009215 8090 10520 12140 13760 14570 15380CT GUIDED PIGTAIL SVC009022 8090 10520 12140 13760 14570 15380CT HEAD & NECK CONTRAST SVC008700 7720 10040 11580 13130 13900 14670CT HEAD & NECK PLAIN SVC008701 5520 7180 8280 9390 9940 10490CT HIGH RISK CONTRAST (VISIPAQUE 270MG ) 100ML SVC009303 2650 3450 3980 4510 4770 5040CT HIGH RISK CONTRAST (VISIPAQUE 270MG ) 50ML SVC009302 1330 1730 2000 2270 2400 2530CT HIP JOINT BOTH SVC008350 4410 5740 6620 7500 7940 8380CT HIP JOINT LEFT SVC008702 4410 5740 6620 7500 7940 8380CT HIP JOINT RIGHT SVC008703 4410 5740 6620 7500 7940 8380CT HUMERUS LEFT SVC009761 4410 5740 6620 7500 7940 8380CT HUMERUS RIGHT SVC008351 4410 5740 6620 7500 7940 8380CT IVP SVC009210 6620 8610 9930 11260 11920 12580CT KIDNEYS DUAL PHASE CONTRAST SVC008704 11030 14340 16550 18760 19860 20960CT KNEE LEFT SVC008352 4410 5740 6620 7500 7940 8380CT KNEE RIGHT SVC008354 4410 5740 6620 7500 7940 8380CT KUB CONTRAST SVC008355 8820 11470 13230 15000 15880 16760CT KUB PLAIN SVC008356 6300 8190 9450 10710 11340 11970CT LEG LEFT SVC009116 4410 5740 6620 7500 7940 8380CT LEG RIGHT SVC009115 4410 5740 6620 7500 7940 8380CT LIVER DONOR POST PROCESSING SVC013523 1050 1370 1580 1790 1890 2000CT LIVER DONOR POST PROCESSING(WITH FILM) SVC013524 1580 2060 2370 2690 2850 3010

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteCT LIVER VOLUMETRY SVC011430 2210 2880 3320 3760 3980 4200CT LS SPINE WITH CONTRAST SVC009248 6620 8610 9930 11260 11920 12580CT LUMBAR SPINE SVC008705 5040 6560 7560 8570 9080 9580CT LUMBOSACRAL SPINE SVC008357 5040 6560 7560 8570 9080 9580CT NECK SVC008358 4410 5740 6620 7500 7940 8380CT NECK & THORAX CONTRAST SVC008707 8820 11470 13230 15000 15880 16760CT NECK & THORAX PLAIN SVC008708 6620 8610 9930 11260 11920 12580CT NECK CONTRAST SVC008359 6620 8610 9930 11260 11920 12580CT ORAL CONTRAST CHARGE SVC013525 1050 1370 1580 1790 1890 2000CT ORBITS SVC008360 4410 5740 6620 7500 7940 8380CT ORBITS CONTRAST SVC008361 6620 8610 9930 11260 11920 12580CT PELVIS SVC008664 4410 5740 6620 7500 7940 8380CT PELVIS CONTRAST SVC009155 6620 8610 9930 11260 11920 12580CT PELVIS WITH HIP JOINTS SVC008709 5300 6890 7950 9010 9540 10070CT PERFUSION SVC013526 5250 6830 7880 8930 9450 9980CT PERIPHERAL VENOGRAM SVC009229 11030 14340 16550 18760 19860 20960CT PETROUS TEMPORAL BONE SVC008362 4410 5740 6620 7500 7940 8380CT PLAIN POST PROCEDURE COLLECTION SVC009694 3310 4310 4970 5630 5960 6290CT PNS SVC008364 4410 5740 6620 7500 7940 8380CT PNS CONTRAST SVC008365 6620 8610 9930 11260 11920 12580CT PULMONARY ANGIOGRAPHY + DVT SVC008688 15440 20080 23160 26250 27800 29340CT RAPID MODULE-SERVICE CHARGES SVC009726 15440 20080 23160 26250 27800 29340CT REVIEW CHARGES SVC009649 1110 1450 1670 1890 2000 2110CT SACRO ILIAC JOINT SVC008366 4410 5740 6620 7500 7940 8380CT SCANOGRAM SVC008713 1990 2590 2990 3390 3590 3790CT SCANOGRAM LOWER LIMBS (BOTH) SVC008367 3310 4310 4970 5630 5960 6290CT SHOULDER LEFT SVC008368 4410 5740 6620 7500 7940 8380CT SHOULDER RIGHT SVC008369 4410 5740 6620 7500 7940 8380CT SINOGRAM SVC009695 5300 6890 7950 9010 9540 10070CT SKULL BASE SVC008714 4410 5740 6620 7500 7940 8380CT SPINE LIMITED SVC008715 4410 5740 6620 7500 7940 8380CT SPINE TWO REGIONS SVC008716 8820 11470 13230 15000 15880 16760

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteCT STROKE PROTOCOL (PKG) PKG021330 10500 10500 13700 15800 17900 20000CT THERAPEUTIC ASPIRATION SVC008371 6620 8610 9930 11260 11920 12580CT THORAX + ABDOMEN + PELVIS CONTRAST SVC008719 11030 14340 16550 18760 19860 20960CT THORAX + ABDOMEN + PELVIS PLAIN SVC008720 8820 11470 13230 15000 15880 16760CT THORAX AND ABDOMEN PLAIN SVC009044 11030 14340 16550 18760 19860 20960CT THORAX CONTRAST SVC008721 7500 9750 11250 12750 13500 14250CT THORAX PLAIN SVC008722 5300 6890 7950 9010 9540 10070CT TRANSPLANT KIDNEY SVC008724 8820 11470 13230 15000 15880 16760CT TRIPHASIC ABDOMEN SVC013527 12600 16380 18900 21420 22680 23940CT TRIPLE RULE OUT (CORONARY + AORTA+ PULMONARY) SVC008673 16540 21510 24810 28120 29780 31430CT TRU CUT BIOPSY SVC008373 6620 8610 9930 11260 11920 12580CT TRU CUT BIOPSY WITH CONTRAST SVC008374 11030 14340 16550 18760 19860 20960CT UROGRAPHY SVC009216 8820 11470 13230 15000 15880 16760CT WHOLE BODY ANGIOGRAPHY(PKG) PKG021331 25200 25200 32800 37800 42900 47900CT WRIST PLAIN SVC008375 4410 5740 6620 7500 7940 8380CTÂ PULMONARY EMBOLISM + DVT (PKG) PKG021364 22100 22100 28800 33200 37600 42000DENTAL XRAY SVC009321 160 210 240 280 290 310DOPPLER ABDOMEN UPPER SVC008376 3310 4310 4970 5630 5960 6290DOPPLER AORTA SVC008377 3310 4310 4970 5630 5960 6290DOPPLER ARTERIAL LOWER LIMB BOTH SVC008378 6300 8190 9450 10710 11340 11970DOPPLER ARTERIAL LOWER LIMB SINGLE SVC008379 3970 5170 5960 6750 7150 7550DOPPLER ARTERIAL UPPER LIMB BOTH SVC008665 6620 8610 9930 11260 11920 12580DOPPLER ARTERIAL UPPER LIMB SINGLE SVC008380 3970 5170 5960 6750 7150 7550DOPPLER CAROTID BOTH SVC008381 3780 4920 5670 6430 6810 7190DOPPLER HEPATIC (LIVER) SVC009032 4310 5610 6470 7330 7760 8190DOPPLER HEPATIC (LTP) SVC011828 3310 4310 4970 5630 5960 6290DOPPLER ILIAC VESSEL SVC009033 3310 4310 4970 5630 5960 6290DOPPLER KIDNEY TRANSPLANT SVC008382 3310 4310 4970 5630 5960 6290DOPPLER PENILE SVC008384 6620 8610 9930 11260 11920 12580DOPPLER RENAL SVC008647 3150 4100 4730 5360 5670 5990DOPPLER SCROTAL SVC008385 3970 5170 5960 6750 7150 7550DOPPLER SPLENO PORTAL SVC008386 2210 2880 3320 3760 3980 4200

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteDOPPLER VARICOSE VEINS LOWER LIMB SINGLE SVC009040 3310 4310 4970 5630 5960 6290DOPPLER VENOUS LOWER LIMB BOTH SVC008387 6300 8190 9450 10710 11340 11970DOPPLER VENOUS LOWER LIMB SINGLE SVC008388 3780 4920 5670 6430 6810 7190DOPPLER VENOUS NECK SVC009217 3150 4100 4730 5360 5670 5990DOPPLER VENOUS UPPER LIMB BOTH SVC008389 6620 8610 9930 11260 11920 12580DOPPLER VENOUS UPPER LIMB SINGLE SVC008390 3970 5170 5960 6750 7150 7550DVD CHARGES SVC011929 420 420 420 420 420 420EMERGENCY ULTRASOUND SVC009290 3970 5170 5960 6750 7150 7550ER NCCT ABDOMEN/KUB SVC009680 3310 4310 4970 5630 5960 6290ERCP - CHECK CHOLANGIOGRAM SVC009024 19200 19200 25000 28800 32700 36500FIBROSCAN OF LIVER SVC009252 5300 5300 6900 8000 9100 10100FLUOROSCOPY SVC009109 1100 1100 1500 1700 1900 2100FLUOROSCOPY GUIDED PROCEDURE SVC009041 2550 3320 3830 4340 4590 4850GASTROGRAPHIN SWALLOW SVC009127 2990 3890 4490 5090 5390 5690GLUE INJECTION (PERIPHERAL AVM) SVC009266 11620 15110 17430 19760 20920 22080GUIDANCE FOR BIOPSY INTRA - OPERATIVE SVC009030 8300 8300 10800 12500 14200 15800GUIDANCE FOR DIAGNOSTIC PROCEDURE-BEDSIDE SVC009676 5520 7180 8280 9390 9940 10490GUIDED NERVE BLOCK SVC011829 6620 8610 9930 11260 11920 12580HR CT CHEST SVC008391 5040 6560 7560 8570 9080 9580HRCT CHEST WITH CONTRAST SVC009015 6620 8610 9930 11260 11920 12580IVC - INFERIOR VENACAVAL ANGIOGRAM SVC009031 15600 15600 20300 23400 26600 29700KIDNEY BIOPSY NEW GUN- INTERVENTIONAL RADIOLOGY SVC009317 9650 12550 14480 16410 17370 18340MAMMOGRAPHY BILATERAL SVC008506 2930 3810 4400 4990 5280 5570MAMMOGRAPHY UNILATERAL SVC008507 1610 2100 2420 2740 2900 3060MR STROKE PROTOCOL (CATEGORY 1) SVC009148 9450 12290 14180 16070 17010 17960MR STROKE PROTOCOL (CATEGORY 2 ) SVC009145 15440 20080 23160 26250 27800 29340MRI ABDOMEN & PELVIS CONTRAST SVC008725 17640 22940 26460 29990 31760 33520MRI ABDOMEN LIMITED STUDY PLAIN SVC008726 5520 7180 8280 9390 9940 10490MRI ABDOMEN UPPER CONTRAST SVC008727 11030 14340 16550 18760 19860 20960MRI ABDOMEN WHOLE SVC008393 12000 15600 18000 20400 21600 22800MRI ABDOMEN WHOLE CONTRAST SVC008394 13230 17200 19850 22500 23820 25140MRI ACUTE CEREBRAL STROKE LIMITED STUDY SVC009269 12130 15770 18200 20630 21840 23050

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteMRI ANGIO ABDOMINAL CONTRAST SVC008395 11030 14340 16550 18760 19860 20960MRI ANGIO CERVICAL CAROTID ARTERIES PLAIN SVC008731 7720 10040 11580 13130 13900 14670MRI ANGIO ONE REGION SVC008733 7720 10040 11580 13130 13900 14670MRI ANGIOGRAM PERIPHERAL CONTRAST SVC008737 13230 17200 19850 22500 23820 25140MRI ANGIOGRAM PERIPHERAL PLAIN SVC008738 9930 12910 14900 16890 17880 18870MRI ANGIOGRAPHY BRAIN SVC008396 5570 7250 8360 9470 10030 10590MRI ANGIOGRAPHY BRAIN WITH CONTRAST SVC008397 8600 11180 12900 14620 15480 16340MRI ANGIOGRAPHY HEAD AND NECK (TOF) SVC009114 8820 11470 13230 15000 15880 16760MRI ANGIOGRAPHY NECK SVC008398 5570 7250 8360 9470 10030 10590MRI ANGIOGRAPHY NECK WITH CONTRAST SVC008399 8600 11180 12900 14620 15480 16340MRI ANGIOGRAPHY RENAL SVC008400 7720 10040 11580 13130 13900 14670MRI ANGIOGRAPHY RENAL WITH CONTRAST SVC008401 11030 14340 16550 18760 19860 20960MRI ANKLE JOINT LEFT SVC008402 7720 10040 11580 13130 13900 14670MRI ANKLE JOINT RIGHT SVC008404 7720 10040 11580 13130 13900 14670MRI ANKLE JOINT RIGHT CONTRAST SVC008405 11030 14340 16550 18760 19860 20960MRI AORTAGRAM-CONTRAST SVC009231 17330 22530 26000 29470 31200 32930MRI ARM HUMERUS LEFT SVC008739 7720 10040 11580 13130 13900 14670MRI ARM HUMERUS RIGHT SVC008740 7720 10040 11580 13130 13900 14670MRI ARTHROGRAPHY-SINGLE JOINT SVC009698 11030 14340 16550 18760 19860 20960MRI ASSESSMENT OF LIVER AND CARDIAC IRON SVC009292 4410 5740 6620 7500 7940 8380MRI BRACHIAL PLEXUS SVC008406 7720 10040 11580 13130 13900 14670MRI BRACHIAL PLEXUS CONTRAST SVC008407 11030 14340 16550 18760 19860 20960MRI BRAIN SVC008408 8350 10860 12530 14200 15030 15870MRI BRAIN CONTRAST SVC008409 11030 14340 16550 18760 19860 20960MRI BRAIN CSF FLOW STUDY SVC009196 3310 4310 4970 5630 5960 6290MRI BRAIN SCREENING SVC008410 5040 6560 7560 8570 9080 9580MRI BRAIN VENOGRAPHY SVC008411 4410 5740 6620 7500 7940 8380MRI BRAIN VENOGRAPHY WITH CONTRAST SVC008412 7720 10040 11580 13130 13900 14670MRI BRAIN WITH MR SPECTROSCOPY SVC009270 17330 22530 26000 29470 31200 32930MRI BREAST SVC008743 7720 10040 11580 13130 13900 14670MRI BREAST CONTRAST SVC008744 12130 15770 18200 20630 21840 23050MRI CARDIAC SVC009234 11030 14340 16550 18760 19860 20960

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteMRI CARDIAC MORPHOLOGY SVC008745 8820 11470 13230 15000 15880 16760MRI CARDIAC STRESS SVC009236 17640 22940 26460 29990 31760 33520MRI CARDIAC WITH CONTRAST SVC009235 14340 18650 21510 24380 25820 27250MRI CD CHARGES SVC009007 320 320 320 320 320 320MRI CERVICAL SPINE SVC008413 8820 11470 13230 15000 15880 16760MRI CERVICAL SPINE CONTRAST SVC008414 11030 14340 16550 18760 19860 20960MRI CERVICAL SPINE SCREENING SVC008415 5040 6560 7560 8570 9080 9580MRI CHEST SVC008416 7720 10040 11580 13130 13900 14670MRI CHEST CONTRAST SVC008417 11030 14340 16550 18760 19860 20960MRI CHOLANGIOGRAPHY (MRCP) SVC008418 8820 11470 13230 15000 15880 16760MRI CISTERNOGRAPHY SVC009213 7720 10040 11580 13130 13900 14670MRI CISTERNOGRAPHY WITH CONTRAST SVC009699 11030 14340 16550 18760 19860 20960MRI CONTRAST CHARGES - 10 ML SVC008419 3310 4310 4970 5630 5960 6290MRI CONTRAST CHARGES - 20 ML SVC008420 5520 7180 8280 9390 9940 10490MRI CV JUNCTION SVC008749 8820 11470 13230 15000 15880 16760MRI DBS PROTOCOL SVC011831 7720 10040 11580 13130 13900 14670MRI DBS PROTOCOL WITH CONTRAST SVC011832 11030 14340 16550 18760 19860 20960MRI DEFAECOGRAPHY 3T SVC009594 9270 12060 13910 15760 16690 17620MRI DIFFUSION SINGLE SEQUENCE SVC009700 2650 3450 3980 4510 4770 5040MRI DORSAL SPINE SVC008421 8820 11470 13230 15000 15880 16760MRI DORSAL SPINE CONTRAST SVC008422 11030 14340 16550 18760 19860 20960MRI DORSAL SPINE SCREENING SVC008423 5040 6560 7560 8570 9080 9580MRI DTI DIFFUSION TENSOR IMAGING SVC008751 5520 7180 8280 9390 9940 10490MRI ELBOW JOINT LEFT SVC008424 7720 10040 11580 13130 13900 14670MRI ELBOW JOINT RIGHT SVC008426 7720 10040 11580 13130 13900 14670MRI ENTEROGRAPHY CONTRAST 3T SVC009589 11030 14340 16550 18760 19860 20960MRI EPILEPSY PROTOCOL SVC009338 8820 11470 13230 15000 15880 16760MRI FACE SVC009268 7880 10250 11820 13400 14190 14980MRI FAT ESTIMATION SVC009697 3310 4310 4970 5630 5960 6290MRI FEMUR LEFT SVC009760 7720 10040 11580 13130 13900 14670MRI FEMUR LEFT WITH CONTRAST SVC009759 11030 14340 16550 18760 19860 20960MRI FEMUR RIGHT SVC008752 7720 10040 11580 13130 13900 14670

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteMRI FEMUR RIGHT WITH CONTRAST SVC008753 11030 14340 16550 18760 19860 20960MRI FERRI-SCAN SVC009300 5520 7180 8280 9390 9940 10490MRI FILM SVC009149 370 490 560 630 670 710MRI FISTULOGRAM SVC009239 7720 10040 11580 13130 13900 14670MRI FOETAL STUDY SVC008754 7720 10040 11580 13130 13900 14670MRI FOOT LEFT SVC009758 7720 10040 11580 13130 13900 14670MRI FOOT RIGHT SVC008428 7720 10040 11580 13130 13900 14670MRI FOREARM LEFT SVC008756 7720 10040 11580 13130 13900 14670MRI FOREARM LEFT WITH CONTRAST SVC009756 11030 14340 16550 18760 19860 20960MRI FOREARM RIGHT SVC008757 7720 10040 11580 13130 13900 14670MRI FOREARM RIGHT WITH CONTRAST SVC008755 11030 14340 16550 18760 19860 20960MRI FUNCTIONAL BOLD 3T SVC009546 8820 11470 13230 15000 15880 16760MRI GLUTEAL REGION SVC008430 7720 10040 11580 13130 13900 14670MRI GUIDED NEURO NAVIGATION WITH CONTRAST STUDY SVC009245 6620 8610 9930 11260 11920 12580MRI HAND LEFT SVC009755 7720 10040 11580 13130 13900 14670MRI HAND RIGHT SVC008432 7720 10040 11580 13130 13900 14670MRI HIP JOINT LEFT SVC008434 7720 10040 11580 13130 13900 14670MRI HIP JOINT LEFT CONTRAST SVC008435 11030 14340 16550 18760 19860 20960MRI HIP JOINT RIGHT SVC008436 7720 10040 11580 13130 13900 14670MRI HIP JOINT RIGHT CONTRAST SVC008437 11030 14340 16550 18760 19860 20960MRI HIP JOINTS BOTH SVC008438 8820 11470 13230 15000 15880 16760MRI KNEE LEFT SVC008439 8350 10860 12530 14200 15030 15870MRI KNEE LEFT CONTRAST SVC008440 11030 14340 16550 18760 19860 20960MRI KNEE RIGHT SVC008441 8350 10860 12530 14200 15030 15870MRI KNEE RIGHT CONTRAST SVC008442 11030 14340 16550 18760 19860 20960MRI KUB SVC009240 9270 12060 13910 15760 16690 17620MRI LEG LEFT SVC008443 7720 10040 11580 13130 13900 14670MRI LEG LEFT CONTRAST SVC008444 11030 14340 16550 18760 19860 20960MRI LEG RIGHT SVC008445 7720 10040 11580 13130 13900 14670MRI LEG RIGHT CONTRAST SVC008446 11030 14340 16550 18760 19860 20960MRI LIVER DYNAMIC CONTRAST SVC008761 13230 17200 19850 22500 23820 25140MRI LUMBAR SPINE SVC008447 8820 11470 13230 15000 15880 16760

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteMRI LUMBAR SPINE CONTRAST SVC008762 11030 14340 16550 18760 19860 20960MRI LUMBOSACRAL PLEXUS SVC009325 9270 12060 13910 15760 16690 17620MRI LUMBOSACRAL PLEXUS WITH CONTRAST SVC009326 12130 15770 18200 20630 21840 23050MRI LUMBOSACRAL SPINE SVC008449 9660 12560 14490 16430 17390 18360MRI LUMBOSACRAL SPINE CONTRAST SVC008450 11030 14340 16550 18760 19860 20960MRI LUMBOSACRAL SPINE SCREENING SVC008451 5300 6890 7950 9010 9540 10070MRI MS PROTOCOL WITH CONTRAST SVC008763 11030 14340 16550 18760 19860 20960MRI MYELOGRAPHY SVC008764 3310 4310 4970 5630 5960 6290MRI NASOPHARYNX SVC008452 7720 10040 11580 13130 13900 14670MRI NASOPHARYNX CONTRAST SVC008453 11030 14340 16550 18760 19860 20960MRI NECK SVC008454 7720 10040 11580 13130 13900 14670MRI NECK CONTRAST SVC008455 10500 13650 15750 17850 18900 19950MRI ONE REGION SVC008769 7720 10040 11580 13130 13900 14670MRI ORBIT CONTRAST SVC008456 11030 14340 16550 18760 19860 20960MRI ORBITS SVC008457 7720 10040 11580 13130 13900 14670MRI PELVIS SVC008458 8400 10920 12600 14280 15120 15960MRI PELVIS CONTRAST SVC008459 11030 14340 16550 18760 19860 20960MRI PELVIS WITH CONTRAST SVC008770 11030 14340 16550 18760 19860 20960MRI PERFUSION SVC008771 5520 7180 8280 9390 9940 10490MRI PERFUSION + DIFFUSION TENSOR IMAGING (DTI) SVC008772 11030 14340 16550 18760 19860 20960MRI PITUITARY SVC008773 8400 10920 12600 14280 15120 15960MRI PNS SVC008774 7720 10040 11580 13130 13900 14670MRI PROSTATE SVC008460 7720 10040 11580 13130 13900 14670MRI PROSTATE WITH CONTRAST SVC008461 12130 15770 18200 20630 21840 23050MRI PROSTATE-MP/SPECTRO SVC009679 16170 21030 24260 27490 29110 30730MRI PROSTATE-Multiparametric (PKG) PKG021369 25200 25200 32800 37800 42900 47900MRI RAPID MODULE-SERVICE CHARGES SVC009727 15440 20080 23160 26250 27800 29340MRI REVIEW CHARGES SVC009650 1330 1730 2000 2270 2400 2530MRI RT. THIGH SVC009255 7720 10040 11580 13130 13900 14670MRI SCREENING SVC009194 5040 6560 7560 8570 9080 9580MRI SEDATION CHARGES SVC008776 4410 5740 6620 7500 7940 8380MRI SHOULDER BOTH JOINTS SVC012878 8670 11280 13010 14740 15610 16480

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteMRI SHOULDER JOINT LEFT SVC008464 7720 10040 11580 13130 13900 14670MRI SHOULDER JOINT LEFT CONTRAST SVC008465 11030 14340 16550 18760 19860 20960MRI SHOULDER JOINT RIGHT SVC008466 7800 10140 11700 13260 14040 14820MRI SHOULDER JOINT RIGHT CONTRAST SVC008467 11030 14340 16550 18760 19860 20960MRI SI JOINT SVC008468 7720 10040 11580 13130 13900 14670MRI SI JOINT CONTRAST SVC008469 11030 14340 16550 18760 19860 20960MRI SI JOINTS BOTH SCREENING SVC008470 5300 6890 7950 9010 9540 10070MRI SIALOGRAM SVC009628 7720 10040 11580 13130 13900 14670MRI SPECTROSCOPY SVC008471 7350 9560 11030 12500 13230 13970MRI SPINE SCREENING WHOLE SVC008473 8400 10920 12600 14280 15120 15960MRI STERNO-CLAVICULAR REGION SVC008525 7720 10040 11580 13130 13900 14670MRI T1 PRE & POST CONTRAST SINGLE SEQUENCE SVC008779 5520 7180 8280 9390 9940 10490MRI TEMPOROMANDIBULAR JOINT SVC008475 7720 10040 11580 13130 13900 14670MRI TEMPOROMANDIBULAR JOINT WITH CONTRAST SVC008476 11030 14340 16550 18760 19860 20960MRI TRIPLE PHASE LIVER SVC009320 13230 17200 19850 22500 23820 25140MRI UROGRAPHY (MRU) SVC008781 9270 12060 13910 15760 16690 17620MRI VENOGRAM SVC008782 7720 10040 11580 13130 13900 14670MRI VENOGRAM CONTRAST SVC009250 11030 14340 16550 18760 19860 20960MRI VENOGRAPHY THORAX / ABDOMEN SVC008783 7720 10040 11580 13130 13900 14670MRI Vessel Wall Imaging Plain SVC013914 10500 13650 15750 17850 18900 19950MRI Vessel Wall Imaging With Contrast SVC013915 12600 16380 18900 21420 22680 23940MRI WHOLE BODY SCREENING SVC008784 7720 10040 11580 13130 13900 14670MRI WHOLE BODY SCREENING(PKG) PKG021368 25200 25200 32800 37800 42900 47900MRI WHOLE SPINE SCREENING(PKG) PKG021367 15200 15200 19800 22800 25900 28900MRI WRIST JOINT LEFT SVC008477 7720 10040 11580 13130 13900 14670MRI WRIST JOINT LEFT CONTRAST SVC008478 11030 14340 16550 18760 19860 20960MRI WRIST JOINT RIGHT SVC008479 7720 10040 11580 13130 13900 14670MRI WRIST JOINT RIGHT CONTRAST SVC008480 11030 14340 16550 18760 19860 20960NCCT CHEST & WHOLE ABDOMEN (PKG) PKG021365 15800 15800 20600 23700 26900 30100PERCUTANEOUS SCLEROTHERPY SVC009254 17400 17400 22700 26100 29600 33100PERCUTANEOUS TRANS HEPATIC BILIARY DRAINGE (PTBD) SVC009025 37400 37400 48700 56100 63600 71100PERIPHERAL ARTERY AMBULATION SVC009249 13230 17200 19850 22500 23820 25140

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuitePRE OP CT CHEST SVC012909 4620 6010 6930 7860 8320 8780RETROGRADE URETHROGRAPHY (RGU) SVC009113 3310 4310 4970 5630 5960 6290TRANSRECTAL BIOPSY SVC009043 9120 11860 13680 15510 16420 17330USG A V FISTULA MAPPING SINGLE LIMB SVC008786 3310 4310 4970 5630 5960 6290USG ABDOMEN SVC008481 1860 2420 2790 3170 3350 3540USG ABDOMEN & PELVIS SVC008787 2210 2880 3320 3760 3980 4200USG ABDOMEN LOWER SVC008482 1220 1590 1830 2080 2200 2320USG ABDOMEN LOWER SCREENING SVC008788 1220 1590 1830 2080 2200 2320USG ABDOMEN UPPER SVC008483 1770 2310 2660 3010 3190 3370USG ABDOMEN WHOLE SVC008485 2210 2880 3320 3760 3980 4200USG ABDOMEN WHOLE SCREENING SVC008486 1860 2420 2790 3170 3350 3540USG BIOPSY SVC008487 6930 9010 10400 11790 12480 13170USG BIOPSY-COMPLEX SVC009674 8820 11470 13230 15000 15880 16760USG BLADDER SVC008790 1220 1590 1830 2080 2200 2320USG BREAST BOTH SVC008489 2100 2730 3150 3570 3780 3990USG BREAST SINGLE SVC008490 1220 1590 1830 2080 2200 2320USG CHEST SVC008491 1220 1590 1830 2080 2200 2320USG CHEST SCREENING SVC008791 1220 1590 1830 2080 2200 2320USG DIAGNOSTIC ASPIRATION SVC008492 3870 5040 5810 6580 6970 7360USG DVD CHARGES SVC011932 340 340 340 340 340 340USG EARLY PREGNANCY (12W) SVC008792 2210 2880 3320 3760 3980 4200USG EARLY PREGNANCY (12W) - TWINS SVC009777 166480 216430 249720 283020 299670 316320USG EYEBALL/ORBIT SVC008793 1220 1590 1830 2080 2200 2320USG EYEBALL/ORBIT(BOTH) SVC009163 1550 2020 2330 2640 2790 2950

USG FAST(FOCUSED ASSESSMENT WITH SONOGRAPHY IN TRAUMA) SVC009691 2500 2500 3300 3800 4300 4800USG FETAL DOPPLER - TWINS SVC009781 155930 202710 233900 265090 280680 296270USG FILM SVC009008 270 360 410 460 490 520USG FNAC SVC008493 3870 5040 5810 6580 6970 7360USG FOETAL WELL BEING SVC008495 4410 5740 6620 7500 7940 8380

USG FOETAL WELL BEING - CONGENITAL ABNORMALITIES (LEVEL II) SVC008662 5520 7180 8280 9390 9940 10490

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteUSG FOETAL WELL BEING (ANAMOLY SCAN) - TWINS SVC009787 182490 237240 273740 310240 328490 346740USG FOLLICULAR STUDY SVC008497 3870 5040 5810 6580 6970 7360USG FOLLOW UP OVULATION SVC008795 590 770 890 1010 1070 1130USG FOR TRANSPLANT KIDNEY SVC008796 2210 2880 3320 3760 3980 4200USG GUIDANCE SVC009692 4200 4200 5500 6300 7200 8000USG GUIDANCE FOR DIAGNOSTIC PROCEDURE SVC009675 3310 4310 4970 5630 5960 6290USG GUIDANCE FOR THERAPEUTIC PROCEDURE SVC009677 4410 5740 6620 7500 7940 8380USG GUIDANCE FOR THERAPEUTIC PROCEDURE-BEDSIDE SVC009678 6620 8610 9930 11260 11920 12580USG GUIDANCE TUMOR MARKING SVC013528 5250 6830 7880 8930 9450 9980USG GUIDANCE TUMOR MARKING (SHORT) SVC013529 3150 4100 4730 5360 5670 5990USG GUIDANCE(SHORT) SVC013530 3150 4100 4730 5360 5670 5990USG GUIDED ABSCESS DRAINAGE SVC009009 5780 7520 8670 9830 10410 10990

USG GUIDED COMPRESSION THROMBOSIS OF PSEUDOANEURYSM SVC008501 7180 9340 10770 12210 12930 13650USG GUIDED FNAC SVC009251 5520 7180 8280 9390 9940 10490USG GUIDED LIVER BIOPSY SVC009011 6620 8610 9930 11260 11920 12580USG GUIDED PIGTAIL SVC009012 6620 8610 9930 11260 11920 12580USG GUIDED PIGTAIL CATHETER DRAINAGE OF PSEUDOCYSTS SVC009299 7940 10330 11910 13500 14300 15090USG GUIDED PSOAS ABSCESS ASPIRATION SVC009276 6620 8610 9930 11260 11920 12580USG HEAD CRANIUM SVC008797 1550 2020 2330 2640 2790 2950USG JOINT SINGLE SVC008798 1550 2020 2330 2640 2790 2950USG KIDNEY/RENAL SVC008503 1220 1590 1830 2080 2200 2320USG KUB SVC008504 1470 1920 2210 2500 2650 2800USG KUB + PVR SVC009655 1770 2310 2660 3010 3190 3370USG LIVER ELASTOGRAPHY SVC009632 2210 2880 3320 3760 3980 4200USG MAMMOGRAPHY + MAMMOSONOGRAPHY BILATERAL SVC008800 2210 2880 3320 3760 3980 4200USG MUSCULOSKELETAL SVC008803 1550 2020 2330 2640 2790 2950USG NECK SVC008508 1580 2060 2370 2690 2850 3010USG NECK DOPPLER PKG021370 4800 4800 6300 7200 8200 9200USG NEUROSONOGRAM SVC008804 1550 2020 2330 2640 2790 2950USG PAROTID SVC008806 1220 1590 1830 2080 2200 2320USG PELVIS SVC008509 1340 1750 2010 2280 2420 2550

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteUSG PENIS SVC009173 2210 2880 3320 3760 3980 4200USG PREGNANCY - TWINS SVC009783 161700 210210 242550 274890 291060 307230USG PREGNANCY (ANOMALY SCAN) SVC008809 4410 5740 6620 7500 7940 8380USG PREGNANCY + DOPPLER & BPP SVC008510 4410 5740 6620 7500 7940 8380USG PREGNANCY + DOPPLER & BPP - TWINS SVC009785 174410 226740 261620 296500 313940 331380USG PREGNANCY DOPPLER SVC009037 3310 4310 4970 5630 5960 6290USG PROSTATE SVC008810 1860 2420 2790 3170 3350 3540USG RESIDUAL URINE SVC008511 340 450 510 580 620 650USG SCROTUM SVC008512 1550 2020 2330 2640 2790 2950USG SHOULDER (SINGLE) SVC009164 2210 2880 3320 3760 3980 4200USG SINGLE ORGAN SVC008811 1460 1900 2190 2490 2630 2780USG SINGLE ORGAN SCREENING SVC008812 780 1020 1170 1330 1410 1490USG TESTIS SVC008513 1550 2020 2330 2640 2790 2950USG THERAPEUTIC ASPIRATION SVC008650 5520 7180 8280 9390 9940 10490USG THIGH SVC008813 1180 1540 1770 2010 2130 2250USG THYROID SVC008514 1220 1590 1830 2080 2200 2320USG TRANSRECTAL SVC008515 1850 2410 2780 3150 3330 3520USG TRANSVAGINAL SVC009118 1550 2020 2330 2640 2790 2950USG TRU CUT BIOPSY SVC008516 6620 8610 9930 11260 11920 12580USG TRUS SVC008517 1550 2020 2330 2640 2790 2950USG TVS SVC008518 2210 2880 3320 3760 3980 4200USG TVS (PELVIS) SVC008807 2210 2880 3320 3760 3980 4200USG UTERUS & ADNEXA SVC008519 1220 1590 1830 2080 2200 2320USG WHOLE ABDOMEN SCREENING SVC008815 1460 1900 2190 2490 2630 2780USG_ GROIN DOPPLER SVC011840 5200 6760 7800 8840 9360 9880UTERINE ARTERY EMBOLIZATION SVC009026 37000 37000 48100 55500 62900 70300VERIFICATION CHARGE CONE BEAM CT SVC009099 14780 19220 22170 25130 26610 28090VERIFICATION CHARGE EPID SVC009100 7430 9660 11150 12640 13380 14120VIDEO FLUOROSCOPY SWALLOW STUDY (VFSS) SVC009436 4090 5320 6140 6960 7370 7780X RAY DCG SVC009272 3820 4970 5730 6500 6880 7260XRAY ABDOMEN ERECT SVC008523 490 640 740 840 890 940XRAY ABDOMEN ERECT AP & LAT SVC008660 590 770 890 1010 1070 1130

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteXRAY ABDOMEN SUPINE AP SVC008524 490 640 740 840 890 940XRAY ANKLE BOTH JOINTS AP SVC008818 590 770 890 1010 1070 1130XRAY ANKLE BOTH JOINTS AP & LAT SVC008819 870 1140 1310 1480 1570 1660XRAY ANKLE BOTH JOINTS LAT SVC008820 590 770 890 1010 1070 1130XRAY ANKLE JOINT LEFT AP SVC008821 390 510 590 670 710 750XRAY ANKLE JOINT LEFT AP & LAT SVC008526 680 890 1020 1160 1230 1300XRAY ANKLE JOINT LEFT LAT SVC008822 390 510 590 670 710 750XRAY ANKLE JOINT RIGHT AP SVC008527 390 510 590 670 710 750XRAY ANKLE JOINT RIGHT AP & LAT SVC008528 680 890 1020 1160 1230 1300XRAY ANKLE JOINT RIGHT LAT SVC008823 390 510 590 670 710 750XRAY ANKLE MORTISE VIEW SVC009291 390 510 590 670 710 750XRAY ANKLE WITH LEG LEFT AP & LAT SVC008529 590 770 890 1010 1070 1130XRAY ANKLE WITH LEG RIGHT AP & LAT SVC008824 720 940 1080 1230 1300 1370XRAY ARM BOTH AP SVC008825 590 770 890 1010 1070 1130XRAY ARM BOTH AP & LAT SVC008826 870 1140 1310 1480 1570 1660XRAY ARM LEFT AP SVC008828 390 510 590 670 710 750XRAY ARM LEFT AP & LAT SVC008829 590 770 890 1010 1070 1130XRAY ARM LEFT LAT SVC008830 390 510 590 670 710 750XRAY ARM RIGHT AP SVC008530 390 510 590 670 710 750XRAY ARM RIGHT AP & LAT SVC008831 590 770 890 1010 1070 1130XRAY ARM RIGHT LAT SVC008832 390 510 590 670 710 750XRAY BARIUM ENEMA DOUBLE CONTRAST SVC008833 4410 5740 6620 7500 7940 8380XRAY BARIUM ENEMA SINGLE CONTRAST SVC008659 3310 4310 4970 5630 5960 6290XRAY BARIUM IC JUNCTION SVC008834 3310 4310 4970 5630 5960 6290XRAY BARIUM MEAL DOUBLE CONTRAST SVC008835 3310 4310 4970 5630 5960 6290XRAY BARIUM MEAL FOLLOW THROUGH BMFT SVC008836 4410 5740 6620 7500 7940 8380XRAY BARIUM MEAL SINGLE CONTRAST SVC008837 3310 4310 4970 5630 5960 6290XRAY BARIUM SWALLOW SVC008838 2770 3610 4160 4710 4990 5270XRAY BOTH KNEE JOINT AP&LAT SVC009424 1360 1770 2040 2320 2450 2590XRAY BOTH TEMPORO MANDIBULAR JOINT CLOSE MOUTH SVC008970 590 770 890 1010 1070 1130XRAY BREAST MAMMOGRAPHY BOTH SVC008839 2210 2880 3320 3760 3980 4200XRAY BREAST MAMMOGRAPHY SINGLE SVC008840 1110 1450 1670 1890 2000 2110

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteXRAY CALCANEUM BOTH LAT & AXIAL SVC008841 870 1140 1310 1480 1570 1660XRAY CALCANEUM LEFT LAT & AXIAL SVC008842 590 770 890 1010 1070 1130XRAY CALCANEUM RIGHT LAT & AXIAL SVC008843 590 770 890 1010 1070 1130XRAY CERVICAL SPINE AP SVC008531 490 640 740 840 890 940XRAY CERVICAL SPINE AP & LAT SVC008532 740 970 1110 1260 1340 1410XRAY CERVICAL SPINE FLE & EXT SVC008855 720 940 1080 1230 1300 1370XRAY CERVICAL SPINE LAT SVC008533 490 640 740 840 890 940XRAY CERVICAL SPINE OBLIQUE SVC008844 590 770 890 1010 1070 1130XRAY CERVICOTHORACIC SPINE AP & LAT SVC008989 590 770 890 1010 1070 1130XRAY CHEST APICAL SVC008534 390 510 590 670 710 750XRAY CHEST APICAL & LORDOTIC SVC008535 590 770 890 1010 1070 1130XRAY CHEST BOTH LAT SVC008536 590 770 890 1010 1070 1130XRAY CHEST FOR RIBS SVC008845 390 510 590 670 710 750XRAY CHEST LATERAL SVC009426 610 800 920 1040 1100 1160XRAY CHEST LEFT LAT SVC008537 390 510 590 670 710 750XRAY CHEST LEFT OBLIQUE SVC008846 390 510 590 670 710 750XRAY CHEST OBLIQUE BOTH SVC008847 590 770 890 1010 1070 1130XRAY CHEST PA SVC008538 460 600 690 790 830 880XRAY CHEST PA & LAT SVC008848 590 770 890 1010 1070 1130XRAY CHEST RIGHT LAT SVC008539 390 510 590 670 710 750XRAY CHEST RIGHT OBLIQUE SVC008849 390 510 590 670 710 750XRAY CHEST-AP SVC009427 490 640 740 840 890 940XRAY CLAVICLE BOTH AP SVC008850 590 770 890 1010 1070 1130XRAY CLAVICLE LEFT AP SVC008851 390 510 590 670 710 750XRAY CLAVICLE RIGHT AP SVC008540 390 510 590 670 710 750XRAY COCCYX AP SVC008852 390 510 590 670 710 750XRAY COCCYX AP & LAT SVC008541 590 770 890 1010 1070 1130XRAY COCCYX LAT SVC008853 390 510 590 670 710 750XRAY DORSAL SPINE AP SVC008542 490 640 740 840 890 940XRAY DORSAL SPINE AP & LAT SVC008543 720 940 1080 1230 1300 1370XRAY DORSAL SPINE LAT SVC008857 490 640 740 840 890 940XRAY DORSOLUMBAR SPINE AP SVC008858 390 510 590 670 710 750

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteXRAY DORSOLUMBAR SPINE AP & LAT SVC008544 590 770 890 1010 1070 1130XRAY DORSOLUMBAR SPINE LAT SVC008859 390 510 590 670 710 750XRAY DVD CHARGES SVC011931 280 280 280 280 280 280XRAY ELBOW BOTH AP & LAT SVC008860 870 1140 1310 1480 1570 1660XRAY ELBOW BOTH LAT SVC008861 590 770 890 1010 1070 1130XRAY ELBOW LEFT AP SVC008862 390 510 590 670 710 750XRAY ELBOW LEFT AP & LAT SVC008545 590 770 890 1010 1070 1130XRAY ELBOW LEFT LAT SVC008863 390 510 590 670 710 750XRAY ELBOW RIGHT AP SVC008546 390 510 590 670 710 750XRAY ELBOW RIGHT AP & LAT SVC008547 590 770 890 1010 1070 1130XRAY ELBOW RIGHT LAT SVC008548 390 510 590 670 710 750XRAY ERCP SVC008864 1770 2310 2660 3010 3190 3370XRAY FEET BOTH (STANDING) LAT SVC008865 590 770 890 1010 1070 1130XRAY FEET BOTH AP SVC008866 590 770 890 1010 1070 1130XRAY FEET BOTH AP & LAT SVC008867 870 1140 1310 1480 1570 1660XRAY FEET BOTH AP & OBLIQUE SVC008868 870 1140 1310 1480 1570 1660XRAY FEET BOTH LAT SVC008869 590 770 890 1010 1070 1130XRAY FEMUR BOTH AP & LAT SVC008871 1020 1330 1530 1740 1840 1940XRAY FEMUR LEFT AP SVC008549 390 510 590 670 710 750XRAY FEMUR LEFT AP & LAT SVC008550 590 770 890 1010 1070 1130XRAY FEMUR LEFT LAT SVC008872 390 510 590 670 710 750XRAY FEMUR RIGHT AP SVC008551 390 510 590 670 710 750XRAY FEMUR RIGHT AP & LAT SVC008552 590 770 890 1010 1070 1130XRAY FEMUR RIGHT LAT SVC008873 390 510 590 670 710 750XRAY FINGER AP & LAT SVC008651 590 770 890 1010 1070 1130XRAY FISTULOGRAM SVC008874 1770 2310 2660 3010 3190 3370XRAY FLUROSCOPY CHEST SVC008875 390 510 590 670 710 750XRAY FOOT & ANKLE LEFT AP & LAT SVC008553 590 770 890 1010 1070 1130XRAY FOOT & ANKLE RIGHT AP & LAT SVC008554 590 770 890 1010 1070 1130XRAY FOOT LEFT AP SVC008555 390 510 590 670 710 750XRAY FOOT LEFT AP AND LAT SVC008556 590 770 890 1010 1070 1130XRAY FOOT LEFT AP AND OBL SVC008557 680 890 1020 1160 1230 1300

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteXRAY FOOT LEFT LAT SVC008558 490 640 740 840 890 940XRAY FOOT RIGHT AP SVC008559 390 510 590 670 710 750XRAY FOOT RIGHT AP & LAT SVC008561 590 770 890 1010 1070 1130XRAY FOOT RIGHT AP AND OBL SVC008560 720 940 1080 1230 1300 1370XRAY FOOT RIGHT LAT SVC008876 390 510 590 670 710 750XRAY FOOT STANDING LAT SVC008877 390 510 590 670 710 750XRAY FOREARM BOTH AP & LAT SVC008878 870 1140 1310 1480 1570 1660XRAY FOREARM LEFT AP SVC008879 390 510 590 670 710 750XRAY FOREARM LEFT AP & LAT SVC008562 590 770 890 1010 1070 1130XRAY FOREARM LEFT LAT SVC008880 390 510 590 670 710 750XRAY FOREARM RIGHT AP SVC008563 390 510 590 670 710 750XRAY FOREARM RIGHT AP & LAT SVC008564 590 770 890 1010 1070 1130XRAY FOREARM RIGHT LAT SVC008881 390 510 590 670 710 750XRAY FOREARM WRIST AP & LAT SVC008882 590 770 890 1010 1070 1130XRAY HAND & WRIST BOTH AP SVC008565 590 770 890 1010 1070 1130XRAY HAND & WRIST BOTH AP & LAT SVC008566 870 1140 1310 1480 1570 1660XRAY HAND & WRIST BOTH LAT SVC008883 590 770 890 1010 1070 1130XRAY HAND LEFT AP SVC008567 390 510 590 670 710 750XRAY HAND LEFT AP & LAT SVC008568 590 770 890 1010 1070 1130XRAY HAND LEFT AP & OBLIQUE SVC008569 590 770 890 1010 1070 1130XRAY HAND LEFT LAT SVC008884 390 510 590 670 710 750XRAY HAND RIGHT AP SVC008570 390 510 590 670 710 750XRAY HAND RIGHT AP & LAT SVC008572 590 770 890 1010 1070 1130XRAY HAND RIGHT AP & OBLIQUE SVC008571 590 770 890 1010 1070 1130XRAY HAND RIGHT LAT SVC008885 390 510 590 670 710 750XRAY HAND SINGLE AP & LAT & OBLIQUE SVC008652 870 1140 1310 1480 1570 1660XRAY HANDS AP SVC008573 480 630 720 820 870 920XRAY HANDS BOTH AP SVC008886 590 770 890 1010 1070 1130XRAY HANDS BOTH AP & LAT SVC009121 870 1140 1310 1480 1570 1660XRAY HANDS BOTH AP & OBLIQUE SVC008887 870 1140 1310 1480 1570 1660XRAY HANDS BOTH LAT SVC009639 710 930 1070 1210 1280 1350XRAY HEEL LEFT AP SVC008574 390 510 590 670 710 750

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteXRAY HEEL LEFT AP & LAT SVC008575 590 770 890 1010 1070 1130XRAY HEEL LEFT LAT SVC008576 390 510 590 670 710 750XRAY HEEL RIGHT AP SVC008577 390 510 590 670 710 750XRAY HEEL RIGHT LAT SVC008578 390 510 590 670 710 750XRAY HEELS BOTH AP SVC008579 590 770 890 1010 1070 1130XRAY HEELS BOTH LAT SVC008580 590 770 890 1010 1070 1130XRAY HIP JOINT LEFT AP SVC008581 490 640 740 840 890 940XRAY HIP JOINT LEFT AP & LAT SVC008582 720 940 1080 1230 1300 1370XRAY HIP JOINT LEFT LAT SVC008583 390 510 590 670 710 750XRAY HIP JOINT RIGHT AP SVC008584 390 510 590 670 710 750XRAY HIP JOINT RIGHT AP & LAT SVC008585 720 940 1080 1230 1300 1370XRAY HIP JOINT RIGHT LAT SVC008586 390 510 590 670 710 750XRAY HIP JOINTS BOTH AP SVC008890 720 940 1080 1230 1300 1370XRAY HIP JOINTS BOTH AP & LAT SVC008891 870 1140 1310 1480 1570 1660XRAY HIP LEFT AP & LAT SVC008892 590 770 890 1010 1070 1130XRAY HIP RIGHT AP SVC008893 480 630 720 820 870 920XRAY HIP RIGHT AP & LAT SVC008894 720 940 1080 1230 1300 1370XRAY HIP RIGHT LAT SVC008895 390 510 590 670 710 750XRAY HIP WITH PROXIMAL FEMUR LEFT AP SVC008896 390 510 590 670 710 750XRAY HIP WITH PROXIMAL FEMUR RIGHT AP SVC008897 390 510 590 670 710 750XRAY HKA VIEW SVC011842 840 1100 1260 1430 1520 1600XRAY HSG SVC008587 3430 4460 5150 5840 6180 6520XRAY HUMERUS AP SVC008898 490 640 740 840 890 940XRAY HUMERUS LAT SVC008899 390 510 590 670 710 750XRAY HUMERUS LEFT AP & LAT SVC008588 590 770 890 1010 1070 1130XRAY HUMERUS RIGHT AP & LAT SVC008589 590 770 890 1010 1070 1130XRAY IMAGE GUIDED PROCEDURE FLURO SVC008900 2210 2880 3320 3760 3980 4200XRAY INDEX FINGER RIGHT AP & LAT SVC008901 590 770 890 1010 1070 1130XRAY INDEX FINGER RIGHT LAT SVC008902 390 510 590 670 710 750XRAY IVP & IVU SVC008590 4970 6470 7460 8450 8950 9450XRAY KNEE (STANDING) LEFT AP & LAT SVC008591 590 770 890 1010 1070 1130XRAY KNEE (STANDING) RIGHT AP & LAT SVC008592 590 770 890 1010 1070 1130

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteXRAY KNEE BOTH AP SVC008593 590 770 890 1010 1070 1130XRAY KNEE BOTH AP & LAT SVC008594 1160 1510 1740 1980 2090 2210XRAY KNEE BOTH LAT SVC008904 590 770 890 1010 1070 1130XRAY KNEE BOTH OBLIQUES SVC008905 590 770 890 1010 1070 1130XRAY KNEE LEFT AP SVC008595 390 510 590 670 710 750XRAY KNEE LEFT AP & LAT SVC008596 720 940 1080 1230 1300 1370XRAY KNEE LEFT LAT SVC008597 390 510 590 670 710 750XRAY KNEE RIGHT AP SVC008598 480 630 720 820 870 920XRAY KNEE RIGHT AP & LAT SVC008599 720 940 1080 1230 1300 1370XRAY KNEE RIGHT LAT SVC008600 490 640 740 840 890 940XRAY KNEE SKYLINE SVC008601 390 510 590 670 710 750XRAY KNEES BOTH (STANDING) AP SVC008653 590 770 890 1010 1070 1130XRAY KNEES BOTH (STANDING) AP & LAT SVC008602 970 1270 1460 1650 1750 1850XRAY KNEES BOTH (STANDING) AP & LAT & SKYLINE SVC008903 1030 1340 1550 1760 1860 1960XRAY KNEES BOTH SKYLINE SVC008603 590 770 890 1010 1070 1130XRAY KUB SVC008604 390 510 590 670 710 750XRAY LEG ANKLE AP & LAT SVC008906 590 770 890 1010 1070 1130XRAY LEG LEFT AP SVC008907 390 510 590 670 710 750XRAY LEG LEFT AP & LAT SVC008605 720 940 1080 1230 1300 1370XRAY LEG LEFT LAT SVC008908 390 510 590 670 710 750XRAY LEG RIGHT AP SVC008910 390 510 590 670 710 750XRAY LEG RIGHT AP & LAT SVC008606 720 940 1080 1230 1300 1370XRAY LEG RIGHT LAT SVC008911 390 510 590 670 710 750XRAY LEG WITH ANKLE JOINT LEFT AP & LAT SVC008912 590 770 890 1010 1070 1130XRAY LEG WITH ANKLE JOINT RIGHT AP & LAT SVC008913 590 770 890 1010 1070 1130XRAY LEG WITH KNEE JOINT LEFT AP & LAT SVC008914 590 770 890 1010 1070 1130XRAY LEG WITH KNEE JOINT RIGHT AP & LAT SVC008915 590 770 890 1010 1070 1130XRAY LEGS BOTH AP & LAT SVC008916 870 1140 1310 1480 1570 1660XRAY LEGS WITH ANKLE JOINT BOTH AP & LAT SVC008607 870 1140 1310 1480 1570 1660XRAY LEGS WITH KNEE JOINT BOTH AP & LAT SVC008917 870 1140 1310 1480 1570 1660XRAY LOWER LEG AP & LAT SVC008909 590 770 890 1010 1070 1130XRAY LOWER LIMBS BOTH AP SVC008919 590 770 890 1010 1070 1130

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteXRAY LUMBAR SPINE AP SVC008920 490 640 740 840 890 940XRAY LUMBAR SPINE AP & LAT SVC008608 720 940 1080 1230 1300 1370XRAY LUMBAR SPINE LAT SVC008921 490 640 740 840 890 940XRAY LUMBO SACRAL SPINE AP SVC008609 490 640 740 840 890 940XRAY LUMBO SACRAL SPINE AP & LAT SVC008610 690 900 1040 1180 1250 1320XRAY LUMBO SACRAL SPINE AP & LAT & OBLIQUE SVC008611 870 1140 1310 1480 1570 1660XRAY LUMBO SACRAL SPINE EXTENSION & FLEXION SVC009108 790 1030 1190 1350 1430 1510XRAY LUMBO SACRAL SPINE LAT SVC008612 490 640 740 840 890 940XRAY LUMBO SACRAL SPINE OBLIQUE SVC008922 390 510 590 670 710 750XRAY MANDABLE AP & LAT SVC008614 590 770 890 1010 1070 1130XRAY MANDIBLE SVC008613 390 510 590 670 710 750XRAY MASTOIDS BOTH SVC008923 590 770 890 1010 1070 1130XRAY MASTOIDS BOTH LAT & OBLIQUE SVC008654 870 1140 1310 1480 1570 1660XRAY MICTURATING CYSTOURE THROGRAM MCU SVC008924 2210 2880 3320 3760 3980 4200XRAY MIDDLE FINGER AP & LAT SVC008925 590 770 890 1010 1070 1130XRAY NASAL BONE SVC008615 390 510 590 670 710 750XRAY NECK AP & LAT SVC008616 590 770 890 1010 1070 1130XRAY NECK CERVICAL SPINE AP SVC008926 390 510 590 670 710 750XRAY NECK CERVICAL SPINE AP & FLEXION & EXTENSION SVC008927 870 1140 1310 1480 1570 1660XRAY NECK CERVICAL SPINE AP & LAT SVC008617 590 770 890 1010 1070 1130XRAY NECK CERVICAL SPINE FLEXION & EXTENSION SVC008930 590 770 890 1010 1070 1130XRAY NECK CERVICAL SPINE LAT SVC008931 390 510 590 670 710 750XRAY NECK LAT SVC008655 390 510 590 670 710 750XRAY NECK NASOPHARYNX LAT SVC008934 390 510 590 670 710 750XRAY NECK SOFT/TISSUE NASOPHARYNX SVC008618 390 510 590 670 710 750XRAY ORBIT AP & LAT SVC008937 590 770 890 1010 1070 1130XRAY ORBITS SVC008938 390 510 590 670 710 750XRAY PELVIS AP SVC008619 490 640 740 840 890 940XRAY PELVIS HIPS BOTH AP SVC008620 490 640 740 840 890 940XRAY PNS SVC008621 390 510 590 670 710 750X-RAY REPORTING SVC009690 120 160 180 210 220 230XRAY RIGHT THUMB OBLIQUE VIEW SVC009322 390 510 590 670 710 750

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteXRAY SACRO COCCYGEAL JUNCTION AP & LAT SVC008941 590 770 890 1010 1070 1130XRAY SACRO ILIAC JOINT BOTH PA & OBLIQUE SVC008944 870 1140 1310 1480 1570 1660XRAY SACRO ILIAC JOINT LEFT OBL SVC008942 390 510 590 670 710 750XRAY SACRO ILIAC JOINT PA SVC008943 590 770 890 1010 1070 1130XRAY SACRO ILIAC JOINT PA & AP & OBLIQUE SVC008945 870 1140 1310 1480 1570 1660XRAY SACRO ILIAC JOINT RIGHT OBLIQUE SVC008946 390 510 590 670 710 750XRAY SACRO ILIAC JOINTS BOTH OBLIQUE SVC008625 590 770 890 1010 1070 1130XRAY SACRO-ILIAC JOINTS AP SVC008626 390 510 590 670 710 750XRAY SCAPHOID VIEWS SVC008947 590 770 890 1010 1070 1130XRAY SCAPULA BOTH AP & LAT SVC008950 870 1140 1310 1480 1570 1660XRAY SCAPULA LEFT AP SVC008952 390 510 590 670 710 750XRAY SCAPULA LEFT LAT SVC008953 390 510 590 670 710 750XRAY SCAPULA RIGHT AP SVC008954 390 510 590 670 710 750XRAY SCAPULA RIGHT LAT SVC008955 390 510 590 670 710 750XRAY SHOULDER BOTH AP SVC008956 590 770 890 1010 1070 1130XRAY SHOULDER BOTH AP & AXILLARY SVC008957 870 1140 1310 1480 1570 1660XRAY SHOULDER BOTH AP & LAT SVC008958 870 1140 1310 1480 1570 1660XRAY SHOULDER BOTH LAT SVC008959 590 770 890 1010 1070 1130XRAY SHOULDER LEFT AP SVC008628 390 510 590 670 710 750XRAY SHOULDER LEFT AP & AXILLARY SVC008629 590 770 890 1010 1070 1130XRAY SHOULDER LEFT AP & LAT SVC008960 590 770 890 1010 1070 1130XRAY SHOULDER LEFT LAT SVC008961 390 510 590 670 710 750XRAY SHOULDER ONE Y VIEW SVC011843 390 510 590 670 710 750XRAY SHOULDER ONE SIDE AP/LAT SVC008630 590 770 890 1010 1070 1130XRAY SHOULDER RIGHT AP SVC008631 390 510 590 670 710 750XRAY SHOULDER RIGHT AP & AXILLARY SVC008632 590 770 890 1010 1070 1130XRAY SHOULDER RIGHT AP & LAT SVC008633 590 770 890 1010 1070 1130XRAY SHOULDER RIGHT LAT SVC008962 390 510 590 670 710 750XRAY SIALOGRAM SVC008963 1770 2310 2660 3010 3190 3370XRAY SINGLE FILM SVC008666 290 380 440 500 530 560XRAY SINGLE THUMB OBLIQUE VIEW SVC009372 390 510 590 670 710 750XRAY SINOGRAM SVC008964 1770 2310 2660 3010 3190 3370

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteXRAY SKULL AP SVC008634 390 510 590 670 710 750XRAY SKULL AP & LAT SVC008966 720 940 1080 1230 1300 1370XRAY SKULL AP OR LAT SVC008978 390 510 590 670 710 750XRAY SKULL BASE SVC008967 390 510 590 670 710 750XRAY SKULL BOTH MANDIBLE AP & LAT & OBLIQUE SVC008968 1080 1410 1620 1840 1950 2060XRAY SKULL BOTH MASTOIDS LAT OBL SVC008969 590 770 890 1010 1070 1130XRAY SKULL LAT SVC008635 390 510 590 670 710 750XRAY SKULL MANDIBLE AP SVC008972 390 510 590 670 710 750XRAY SKULL MASTOIDS TOWNES SVC008636 390 510 590 670 710 750XRAY SKULL NASAL BONE LAT SVC008974 390 510 590 670 710 750XRAY SKULL ORBITS AP SVC008975 390 510 590 670 710 750XRAY SKULL PNS SVC008976 390 510 590 670 710 750XRAY SKULL TOWNES VIEW SVC008979 390 510 590 670 710 750XRAY SKYLINE VIEW OF PATELLA SVC008980 390 510 590 670 710 750XRAY SPINE AP & LAT VIEW SVC009295 710 930 1070 1210 1280 1350XRAY STERNUM AP & LAT SVC008981 590 770 890 1010 1070 1130XRAY T M JOINT SVC009434 610 800 920 1040 1100 1160XRAY T TUBE STUDIES SVC008638 2130 2770 3200 3630 3840 4050XRAY TEMPORO MANDIBULAR JOINT OPEN MOUTH SVC008986 390 510 590 670 710 750XRAY THIGH AP & LAT SVC008656 720 940 1080 1230 1300 1370XRAY THORACIC SPINE AP SVC009323 390 510 590 670 710 750XRAY THORACIC SPINE AP & LAT SVC008657 590 770 890 1010 1070 1130XRAY THORACO LUMBAR SPINE AP & LAT SVC009243 590 770 890 1010 1070 1130XRAY THUMB SINGLE AP & LAT SVC008991 590 770 890 1010 1070 1130XRAY TIBIA SVC008992 390 510 590 670 710 750XRAY TIBIA BOTH AP & LAT SVC008995 870 1140 1310 1480 1570 1660XRAY TIBIA LEFT AP & LAT SVC008994 590 770 890 1010 1070 1130XRAY TIBIA RIGHT AP & LAT SVC008996 590 770 890 1010 1070 1130XRAY TIBIA WITH KNEE & ANKLE LEFT AP & LAT SVC008997 590 770 890 1010 1070 1130XRAY TIBIA WITH KNEE & ANKLE RIGHT AP & LAT SVC008998 590 770 890 1010 1070 1130XRAY TOE BIG AP & LAT SVC008999 590 770 890 1010 1070 1130XRAY VIDEO FLUROSCOPY SVC009000 1090 1420 1640 1860 1970 2080

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteXRAY WHOLE SPINE SCANOGRAM SVC011844 840 1100 1260 1430 1520 1600XRAY WRIST BOTH AP & LAT SVC009001 1020 1330 1530 1740 1840 1940XRAY WRIST LEFT AP SVC008639 390 510 590 670 710 750XRAY WRIST LEFT AP & LAT SVC008640 680 890 1020 1160 1230 1300XRAY WRIST LEFT AP & LAT & OBLIQUE SVC008658 870 1140 1310 1480 1570 1660XRAY WRIST LEFT AP & SCAPHOID SVC009003 590 770 890 1010 1070 1130XRAY WRIST LEFT LAT SVC008641 390 510 590 670 710 750XRAY WRIST LEFT SCAPHOID SVC009004 390 510 590 670 710 750XRAY WRIST RIGHT AP SVC008642 390 510 590 670 710 750XRAY WRIST RIGHT AP & LAT SVC008643 720 940 1080 1230 1300 1370XRAY WRIST RIGHT AP & SCAPHOID SVC009005 590 770 890 1010 1070 1130XRAY WRIST RIGHT AP, LAT & OBL SVC008624 870 1140 1310 1480 1570 1660XRAY WRIST RIGHT LAT SVC008644 390 510 590 670 710 750XRAY WRIST RIGHT SCAPHOID SVC009006 390 510 590 670 710 750CT TRAUMA PROTOCOL PKG016393 13300 13300 17300 20000 22700 25300

3 CLAMP CAST (HEAD) SVC009853 4500 4500 5900 6800 7700 86003 CLAMP HEAD HYBRID SVC009852 4500 4500 5900 6800 7700 86003 CLAMP PEDIATRIC HEAD SVC009851 4500 4500 5900 6800 7700 86003DCRT- (DELIVERY ) SVC009906 99800 99800 129800 149700 169700 1897003DCRT- (PLANNING ) SVC009820 32600 32600 42400 48900 55500 620004 CLAMP (ABDOMEN) SVC009857 4500 4500 5900 6800 7700 86004 CLAMP (THORAX) SVC009856 4500 4500 5900 6800 7700 86004 CLAMP HEAD AND NECK SVC009854 4500 4500 5900 6800 7700 86004D CT PLANNING SVC009864 13300 13300 17300 20000 22700 253005 CLAMP (HEAD AND NECK) SVC009855 4500 4500 5900 6800 7700 86006 CLAMP SVC009858 4500 4500 5900 6800 7700 86006 CLAMP (NTA) SVC009859 4500 4500 5900 6800 7700 8600ABC- (DELIVERY ) SVC009913 245900 245900 319700 368900 418100 467300ABC- (PLANNING ) SVC009827 84900 84900 110400 127400 144400 161400ADAPTIVE IGRT- (DELIVERY ) SVC009933 201800 201800 262400 302700 343100 383500ADAPTIVE IGRT- (PLANNING ) SVC009847 84900 84900 110400 127400 144400 161400

Radiotherapy

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteADAPTIVE IMRT- (DELIVERY ) SVC009915 190800 190800 248100 286200 324400 362600ADAPTIVE IMRT- (PLANNING ) SVC009829 84900 84900 110400 127400 144400 161400ADJUVANT RT- (DELIVERY ) SVC009904 65100 65100 84700 97700 110700 123700ADJUVANT RT- (PLANNING ) SVC009818 28700 28700 37400 43100 48800 54600ANAL BRACHY- (DELIVERY ) SVC009894 50500 50500 65700 75800 85900 96000ANAL BRACHY- (PLANNING ) SVC009808 4700 4700 6200 7100 8000 9000CONVENTIONAL- (DELIVERY ) SVC009903 59600 59600 77500 89400 101400 113300CONVENTIONAL- (PLANNING ) SVC009817 28700 28700 37400 43100 48800 54600CSI- (DELIVERY ) SVC009921 157700 157700 205100 236600 268100 299700CSI- (PLANNING ) SVC009835 84900 84900 110400 127400 144400 161400CT RT PLANNING PLAIN SVC009861 6700 6700 8800 10100 11400 12800CT RT PLANNING TRIPPLE PHASE SVC009862 11100 11100 14500 16700 18900 21100CT RT PLANNING WITH CONTRAST SVC009863 8900 8900 11600 13400 15200 17000DOTATATE PET CT SCAN SVC009791 174200 226460 261300 296140 313560 330980ELECTRON RADICAL - (DELIVERY ) SVC009936 105900 105900 137700 158900 180100 201300ELECTRON RADICAL - (PLANNING ) SVC009850 32000 32000 41600 48000 54400 60800EXTENDED IGRT- (DELIVERY ) SVC009932 279000 279000 362700 418500 474300 530100EXTENDED IGRT- (PLANNING ) SVC009846 84900 84900 110400 127400 144400 161400EXTENDED IMRT- (DELIVERY ) SVC009914 268000 268000 348400 402000 455600 509200EXTENDED IMRT- (PLANNING ) SVC009828 84900 84900 110400 127400 144400 161400EXTRACORPOREAL RADIATION- (DELIVERY ) SVC009922 33100 33100 43100 49700 56300 62900EXTRACORPOREAL RADIATION- (PLANNING ) SVC009836 11100 11100 14500 16700 18900 21100FREEZING SVC009954 60800 60800 79100 91200 103400 115600FROZEN EMBYO TRANSFER SVC009955 53400 53400 69500 80100 90800 101500FSRS 3-5 COMPLEX- (DELIVERY ) SVC009872 192900 192900 250800 289400 328000 366600FSRS 3-5 SIMPLE- (DELIVERY ) SVC009871 149000 149000 193700 223500 253300 283100FSRS 3-5# SIMPLE PACKAGE PKG021455 323400 323400 420500 485100 549800 614500HEMIBODY RADIATION - (DELIVERY ) SVC009924 27600 27600 35900 41400 47000 52500HEMIBODY RADIATION - (PLANNING ) SVC009838 49700 49700 64700 74600 84500 94500ICRT IMPLANT- (DELIVERY ) SVC009882 19700 19700 25700 29600 33500 37500ICRT IMPLANT- (PLANNING ) SVC009796 13500 13500 17600 20300 23000 25700ICRT PER FRACTION- (DELIVERY ) SVC009881 10900 10900 14200 16400 18600 20800

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteICRT PER FRACTION- (PLANNING ) SVC009795 13500 13500 17600 20300 23000 25700IGRT >40 (DELIVERY ) SVC009928 293800 293800 382000 440700 499500 558300IGRT >40 (PLANNING ) SVC009842 75900 75900 98700 113900 129100 144300IGRT 15 (DELIVERY ) SVC009925 141300 141300 183700 212000 240300 268500IGRT 15 (PLANNING ) SVC009839 66700 66700 86800 100100 113400 126800IGRT 30 (DELIVERY ) SVC009926 233100 233100 303100 349700 396300 442900IGRT 30 (PLANNING ) SVC009840 73000 73000 94900 109500 124100 138700IGRT 31-40 (DELIVERY ) SVC009927 262000 262000 340600 393000 445400 497800IGRT 31-40 (PLANNING ) SVC009841 73000 73000 94900 109500 124100 138700IGRT WITH 4D GATING- (DELIVERY ) SVC009929 268000 268000 348400 402000 455600 509200IGRT WITH 4D GATING- (PLANNING ) SVC009843 84900 84900 110400 127400 144400 161400IGRT WITH ABC- (DELIVERY ) SVC009931 268000 268000 348400 402000 455600 509200IGRT WITH ABC- (PLANNING ) SVC009845 84900 84900 110400 127400 144400 161400IGRT WITH DIBH- (DELIVERY ) SVC009930 268000 268000 348400 402000 455600 509200IGRT WITH DIBH- (PLANNING ) SVC009844 84900 84900 110400 127400 144400 161400ILRT BRON/ESO/NPX- (DELIVERY ) SVC009891 10900 10900 14200 16400 18600 20800ILRT BRON/ESO/NPX- (PLANNING ) SVC009805 4700 4700 6200 7100 8000 9000IMRT 15 (DELIVERY ) SVC009907 98600 98600 128200 147900 167700 187400IMRT 15 (PLANNING ) SVC009821 66700 66700 86800 100100 113400 126800IMRT 30 (DELIVERY ) SVC009908 139800 139800 181800 209700 237700 265700IMRT 30 (PLANNING ) SVC009822 69700 69700 90700 104600 118500 132500IMRT BOOST- (DELIVERY ) SVC009919 33100 33100 43100 49700 56300 62900IMRT BOOST- (PLANNING ) SVC009833 27600 27600 35900 41400 47000 52500IMRT WITH 4D GATING- (DELIVERY ) SVC009911 245900 245900 319700 368900 418100 467300IMRT WITH 4D GATING- (PLANNING ) SVC009825 84900 84900 110400 127400 144400 161400IMRT WITH DIBH- (DELIVERY ) SVC009912 245900 245900 319700 368900 418100 467300IMRT WITH DIBH- (PLANNING ) SVC009826 84900 84900 110400 127400 144400 161400IMRT>40 (DELIVERY ) SVC009910 178300 178300 231800 267500 303200 338800IMRT>40 (PLANNING ) SVC009824 75900 75900 98700 113900 129100 144300IMRT31-40 (DELIVERY ) SVC009909 169600 169600 220500 254400 288400 322300IMRT31-40 (PLANNING ) SVC009823 73000 73000 94900 109500 124100 138700INTRA-OP (SARCOMA)- (DELIVERY ) SVC009890 6900 6900 9000 10400 11800 13200

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteINTRA-OP (SARCOMA)- (PLANNING ) SVC009804 6900 6900 9000 10400 11800 13200ISRT BOOST- (DELIVERY ) SVC009889 37300 37300 48500 56000 63500 70900ISRT BOOST- (PLANNING ) SVC009803 6900 6900 9000 10400 11800 13200ISRT BREAST (APBI)- (DELIVERY ) SVC009888 31800 31800 41400 47700 54100 60500ISRT BREAST (APBI)- (PLANNING ) SVC009802 45500 45500 59200 68300 77400 86500ISRT RADICAL HN- (DELIVERY ) SVC009886 48300 48300 62800 72500 82200 91800ISRT RADICAL HN- (PLANNING ) SVC009800 45500 45500 59200 68300 77400 86500ISRT RADICAL HN BOOST- (DELIVERY ) SVC009887 23400 23400 30500 35100 39800 44500ISRT RADICAL HN BOOST- (PLANNING ) SVC009801 23400 23400 30500 35100 39800 44500MRI RT PLANNING SVC009860 13300 13300 17300 20000 22700 25300MULTIPLE SITES FRACTIONATED- (DELIVERY ) SVC009901 33100 33100 43100 49700 56300 62900MULTIPLE SITES FRACTIONATED- (PLANNING ) SVC009815 22100 22100 28800 33200 37600 42000MULTIPLE SITES ON 1 DAY- (DELIVERY ) SVC009900 22100 22100 28800 33200 37600 42000MULTIPLE SITES ON 1 DAY- (PLANNING ) SVC009814 11100 11100 14500 16700 18900 21100MUPIT- (DELIVERY ) SVC009885 81400 81400 105900 122100 138400 154700MUPIT- (PLANNING ) SVC009799 12400 12400 16200 18600 21100 23600OVOIDS- (DELIVERY ) SVC009883 15800 15800 20600 23700 26900 30100OVOIDS- (PLANNING ) SVC009797 4700 4700 6200 7100 8000 9000PALLIATIVE MULTIPLE - (DELIVERY ) SVC009899 49700 49700 64700 74600 84500 94500PALLIATIVE MULTIPLE - (PLANNING ) SVC009813 11100 11100 14500 16700 18900 21100PALLIATIVE SHORT COURSE IMRT- (DELIVERY ) SVC009902 52400 52400 68200 78600 89100 99600PALLIATIVE SHORT COURSE IMRT- (PLANNING ) SVC009816 52400 52400 68200 78600 89100 99600PALLIATIVE SINGLE WITH SIMULATION - (DELIVERY ) SVC009898 27600 27600 35900 41400 47000 52500PALLIATIVE SINGLE WITH SIMULATION - (PLANNING ) SVC009812 11100 11100 14500 16700 18900 21100PALLIATIVE SINGLE WITHOUT SIM- (DELIVERY ) SVC009897 13300 13300 17300 20000 22700 25300PALLIATIVE SINGLE WITHOUT SIM- (PLANNING ) SVC009811 8900 8900 11600 13400 15200 17000PET BASED IMRT- (DELIVERY ) SVC009916 130100 130100 169200 195200 221200 247200PET BASED IMRT- (PLANNING ) SVC009830 79400 79400 103300 119100 135000 150900PET BASED IMRT ADAPTIVE- (DELIVERY ) SVC009918 163200 163200 212200 244800 277500 310100PET BASED IMRT ADAPTIVE- (PLANNING ) SVC009832 84900 84900 110400 127400 144400 161400PET BASED IMRT WITH 4D GATING- (DELIVERY ) SVC009917 163200 163200 212200 244800 277500 310100PET BASED IMRT WITH 4D GATING- (PLANNING ) SVC009831 84900 84900 110400 127400 144400 161400

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuitePROSTATE BRACHY- (DELIVERY ) SVC009895 37300 37300 48500 56000 63500 70900PROSTATE BRACHY- (PLANNING ) SVC009809 6900 6900 9000 10400 11800 13200PROSTATE SEED- (DELIVERY ) SVC009896 49700 49700 64700 74600 84500 94500PROSTATE SEED- (PLANNING ) SVC009810 5600 5600 7300 8400 9600 10700RADICAL RT- (DELIVERY ) SVC009905 70600 70600 91800 105900 120100 134200RADICAL RT- (PLANNING ) SVC009819 28700 28700 37400 43100 48800 54600RAPID ARC IGRT- (DELIVERY ) SVC009935 236300 236300 307200 354500 401800 449000RAPID ARC IGRT- (PLANNING ) SVC009849 72500 72500 94300 108800 123300 137800RAPID ARC IGRT WITH 4D GATING- (DELIVERY ) SVC009934 268000 268000 348400 402000 455600 509200RAPID ARC IGRT WITH 4D GATING- (PLANNING ) SVC009848 84900 84900 110400 127400 144400 161400RAPID ARC IMRT- (DELIVERY ) SVC009920 148100 148100 192600 222200 251800 281400RAPID ARC IMRT- (PLANNING ) SVC009834 72500 72500 94300 108800 123300 137800RE SRS PACKAGE PKG021215 190600 190600 247800 285900 324100 362200SBRT LIVER 3-5#- PACKAGE PKG021461 346400 346400 450400 519600 588900 658200SBRT LIVER 6-10#- PACKAGE PKG021462 404500 404500 525900 606800 687700 768600SBRT LUNG 3-5# PACKAGE PKG021216 346500 346500 450500 519800 589100 658400SBRT LUNG 6-10# PACKAGE PKG021217 404300 404300 525600 606500 687400 768200SBRT MULTIPLE SITES PACKAGE PKG021218 323400 323400 420500 485100 549800 614500SBRT PALLIATIVE PACKAGE PKG021219 144400 144400 187800 216600 245500 274400SBRT SPINE 1# PACKAGE PKG021220 213700 213700 277900 320600 363300 406100SBRT SPINE 3# PACKAGE PKG021221 231000 231000 300300 346500 392700 438900SORBO PER FRACTION- (DELIVERY ) SVC009884 8600 8600 11200 12900 14700 16400SORBO PER FRACTION- (PLANNING ) SVC009798 8000 8000 10400 12000 13600 15200SRS COMPLEX PACKAGE PKG021222 253600 253600 329700 380400 431200 481900SRS PALL/BOOST COMPLEX- (DELIVERY ) SVC009868 44100 44100 57400 66200 75000 83800SRS PALL/BOOST COMPLEX- (PLANNING ) SVC009773 93800 93800 122000 140700 159500 178300SRS PALL/BOOST SIMPLE PACKAGE PKG021223 194100 194100 252400 291200 330000 368800SRS SIMPLE PACKAGE PKG021224 231000 231000 300300 346500 392700 438900SRT- (DELIVERY ) SVC009870 99300 99300 129100 149000 168900 188700SRT- (PLANNING ) SVC009775 161700 161700 210300 242600 274900 307300SURFACE MOLD BOOST- (DELIVERY ) SVC009893 59400 59400 77300 89100 101000 112900SURFACE MOLD BOOST- (PLANNING ) SVC009807 1400 1400 1900 2100 2400 2700

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteSURFACE MOLD RADICAL- (DELIVERY ) SVC009892 81400 81400 105900 122100 138400 154700SURFACE MOLD RADICAL- (PLANNING ) SVC009806 1400 1400 1900 2100 2400 2700TBI- (DELIVERY ) SVC009923 44100 44100 57400 66200 75000 83800TBI- (PLANNING ) SVC009837 49700 49700 64700 74600 84500 94500USG FIBROSCAN SVC009789 166480 216430 249720 283020 299670 316320USG NT SCAN - TWINS SVC009779 174200 226460 261300 296140 313560 330980

ANTERIOR INSTRUMENTATION SVC010620 43000 55900 64500 73100 81700CERVICAL DISCECTOMY ANTERIOR WITH FUSION SVC010619 46200 60100 69300 78600 87800Cervical Laminectomy SVC013229 26300 34200 39500 44800 50000CERVICAL LAMINECTOMY / POSTERIOR FUSION SINGLE SVC010599 61700 80300 92600 104900 117300CERVICAL LAMINOPLASTY SVC010628 52000 67600 78000 88400 98800COMBINED ANTERIOR AND POSTERIOR SPINAL SURGERY SVC010621 86700 112800 130100 147400 164800DISCECTOMY SVC010625 50800 66100 76200 86400 96600KYPHOPLASTY SVC010602 28300 36800 42500 48200 53800LUMBAR DISCECTOMY SVC010603 25000 32500 37500 42500 47500MINIMAL INVASIVE DISCECTOMY SVC010627 40200 52300 60300 68400 76400NERVE ROOT BLOCK SVC010605 5500 7200 8300 9400 10500ODONTOID SCREW FIXATION SVC010606 41600 54100 62400 70800 79100SCOLIOSIS SURGERY - ANTERIOR RELEASE (MAJOR) SVC010607 63600 82700 95400 108200 120900SCOLIOSIS SURGERY - ANTERIOR RELEASE (MINOR) SVC010608 63600 82700 95400 108200 120900SCOLIOSIS SURGERY - POST INSTRUMENTATION (MAJOR) SVC010609 63600 82700 95400 108200 120900SCOLIOSIS SURGERY - POST INSTRUMENTATION (MINOR) SVC010610 63600 82700 95400 108200 120900TOTAL DISC REPLACEMENT CERVICAL (MULTIPLE LEVEL) SVC010613 63600 82700 95400 108200 120900TOTAL DISC REPLACEMENT CERVICAL (SINGLE LEVEL) SVC010614 55500 72200 83300 94400 105500TOTAL DISC REPLACEMENT LUMBAR SVC010615 44500 57900 66800 75700 84600TRANSFORAMINAL LUMBAR INTERBODY FUSION SVC010616 63600 82700 95400 108200 120900VERTEBROPLASTY SVC010617 28700 37400 43100 48800 54600NUCLEOPLASTY SVC003332 22320 22320 29020 33480 37940 42410

ABDOMINOPLASTY COMPLEX_GST SVC003236 39300 51100 59000 66900 74700ABDOMINOPLASTY MINOR_GST SVC003235 28900 37600 43400 49200 55000

Surgical Oncology

Spine Surgery

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteADVANCED NECK SURGERY (CAROTID BODY TUMOR, RADICAL NECK DISSECTION, NECK SCHWANOMA ETC) SVC003199 32400 42200 48600 55100 61600BILATERAL NECK DISSECTION SVC003234 38300 49800 57500 65200 72800BURNS CONTRACTURE RELEASE + MAJOR FLAP COVER SVC003229 13300 17300 20000 22700 25300DERMOID CYST EXCISION SVC003239 12900 16800 19400 22000 24600FACE LIFT_GST SVC003245 63000 81900 94500 107100 119700FREE FLAP / RECONSTRUCTION SVC003196 57800 75200 86700 98300 109900HEMANGIOMA EXCISION MAJOR SVC003251 16500 21500 24800 28100 31400HEMIGLOSSECTOMY SVC003280 48000 62400 72000 81600 91200LARYNGECTOMY SVC003207 45300 58900 68000 77100 86100LASER EXCISION (VOCAL CORD, ORAL CAVITY EXCISION, ETC) SVC003215 28900 37600 43400 49200 55000LIPOSCUTION MEDIUM AREA_GST SVC003244 33900 44100 50900 57700 64500LIPOSUCTION LARGE AREA_GST SVC003243 31200 40600 46800 53100 59300LIPOSUCTION SMALL AREA (COMPLEX) SVC003301 18500 24100 27800 31500 35200LIPOSUCTION SMALL AREA_GST SVC003242 12800 16700 19200 21800 24400LOCAL FLAP RECONSTRUCTION SVC003202 17400 22700 26100 29600 33100MAXILLECTOMY SVC003209 48700 63400 73100 82800 92600MICROLARYNGOSCOPY EXCISION OF MASS COMPLEX SVC011961 23100 30100 34700 39300 43900MICROLARYNGOSCOPY EXCISION OF MASS SIMPLE SVC011960 17400 22700 26100 29600 33100NASAL ENDOSCOPY BIOPSY GA SVC003274 3500 3500 4600 5300 6000 6700NECK DISSECTION SVC003201 23100 30100 34700 39300 43900NERVE GRAFTING SVC011959 17400 22700 26100 29600 33100PARATHYROIDECTOMY SVC003253 24900 32400 37400 42400 47400PARATHYROIDECTOMY RADIOGUIDED SVC003254 34700 45200 52100 59000 66000PAROTIDECTOMY SVC003200 32400 42200 48600 55100 61600PARTIAL GLOSSECTOMY SVC003281 21000 27300 31500 35700 39900PECTORALIN MAJOR MYOCUTANIOUS FLAP (PMMC) SVC003305 23100 30100 34700 39300 43900SKULL BASE SURGERY SVC003205 51800 67400 77700 88100 98500SPLIT SKIN GRAFTING MAJOR SVC003222 18300 23800 27500 31200 34800SPLIT SKIN GRAFTING MINOR SVC003221 5800 7600 8700 9900 11100SUB MANDIBULAR GLAND EXCISION SVC003203 18500 24100 27800 31500 35200SUPERFICIAL PAROTIDECTOMY SVC003204 23100 30100 34700 39300 43900

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteSUPERFICIAL PAROTIDECTOMY (COMPLEX) SVC003300 40500 52700 60800 68900 77000SURGICAL RE EXPLORATION SVC003210 17400 22700 26100 29600 33100THYROPLASTY SVC003206 34000 44200 51000 57800 64600TOTAL GLOSSECTOMY SVC011624 23100 30100 34700 39300 43900TOTAL MAXILLECTOMY SVC011808 34700 45200 52100 59000 66000TRACHEOESOPHAGEAL PROSTHESIS_ CHANGE SVC011958 5800 7600 8700 9900 11100TRACHO ESOPHAGEAL PROSTHESIS (TEP) INSERTION SVC003233 11600 15100 17400 19800 22100UNILATERAL BREAST AUGMENTATION WITH IMPLANTS_GST SVC003247 31200 40600 46800 53100 59300UNILATERAL BREAST REDUCTION_GST SVC003248 43000 55900 64500 73100 81700CHEMO PORT REMOVAL- GA SVC006779 3800 5000 5700 6500 7300DIAGNOSTIC THORACOSCOPY SVC010633 29500 38400 44300 50200 56100EXPLORATORY THORACOTOMY SVC010634 26300 34200 39500 44800 50000PARAPHARYNGEAL TUMOUR EXCISION SVC002248 25000 32500 37500 42500 47500Abdominal Mass Excision SVC012030 20800 27100 31200 35400 39600ALVEOLECTOMY ( UPPER) PER ORAL SVC006920 22900 29800 34400 39000 43600ALVEOLECTOMY (BOTH JAWS) SVC006921 6400 8400 9600 10900 12200ALVEOLECTOMY (ONE JAWS) SVC006922 3400 4500 5100 5800 6500ALVEOLUS COMPOSITE RESECTION/ COMMANDO SVC006924 48300 62800 72500 82200 91800AXILLARY LYMPH NODE DISSECTION SVC006872 33900 44100 50900 57700 64500BILATERAL MODIFIED NECK DISSECTION SVC012216 46200 60100 69300 78600 87800BREAST RECONSTUCTION WITH MICROVASCULAR FLAP SVC006873 53400 69500 80100 90800 101500BUCCAL FAT TRANSPOSITION SVC013356 10500 13700 15800 17900 20000BUCCAL MUCOSA COMPOSITE RESECTION/COMMANDO SVC006910 33900 44100 50900 57700 64500BUCCAL MUCOSA WIDE EXCISION SVC006915 25500 33200 38300 43400 48500CENTRAL COMPARTMENT CLEARANCE SVC006926 38200 49700 57300 65000 72600CHEMO PORT INSERTION SVC006874 8100 8100 10600 12200 13800 15400CHEMO PORT INSERTION GA SVC006906 5800 5800 7600 8700 9900 11100COLORECTAL ANASTOMOSIS SVC006918 32200 41900 48300 54800 61200COLOSTOMY CLOSURE SVC006875 19700 25700 29600 33500 37500CORONOIDECTOMY SVC013355 15800 20600 23700 26900 30100DILATATION & CURETTAGE SVC006876 4700 4700 6200 7100 8000 9000EUA + BIOPSY SVC012214 4100 4100 5400 6200 7000 7800

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteEXAMINATION UNDER ANAESTHESIA SVC006877 2400 2400 3200 3600 4100 4600EXTERNAL CAROTID ARTERY LIGATION SVC012220 17400 22700 26100 29600 33100FEEDING JEJUNOSTOMY SVC006879 13900 18100 20900 23700 26500FLAP DEVISION SVC012219 10500 13700 15800 17900 20000FLAP DIVISION AND INSETTING SVC006928 38200 49700 57300 65000 72600FREE FIBULA FOR MANDIBULAR RECONSTRUCTION SVC006914 46200 60100 69300 78600 87800HANDSFREE VOICE DEVICE INSERTION SVC013353 10500 13700 15800 17900 20000HEMICOLECTOMY SVC006880 25500 33200 38300 43400 48500Hepatic Metastatectomy SVC012040 23100 30100 34700 39300 43900Infratemporal fossa clearance SVC012013 23100 30100 34700 39300 43900LAPAROSCOPIC ADRENALECTOMY SVC006882 50400 65600 75600 85700 95800LAPAROSCOPIC RADICAL NEPHRECTOMY SVC006883 43800 57000 65700 74500 83300Laser Fulguration/Excision Trachea SVC012019 10500 13700 15800 17900 20000MANDIBULECTOMY SEGMENTAL SVC006912 23100 30100 34700 39300 43900MAXILLECTOMY PARTIAL SVC006938 28900 37600 43400 49200 55000MEDIASTINAL TUMORS EXCISION SVC006888 39000 50700 58500 66300 74100MEDIASTINOSCOPY SVC006889 29500 38400 44300 50200 56100MICROLARYNGOSCOPY SVC012215 9300 9300 12100 14000 15900 17700MODIFIED NECK DISSECTION SVC006916 30100 39200 45200 51200 57200NECK EXPLORATION SVC006927 22900 29800 34400 39000 43600OPEN RADICAL NEPHRECTOMY SVC006902 34700 45200 52100 59000 66000OPEN RADICAL NEPHRECTOMY (COMPLEX) SVC006909 44500 57900 66800 75700 84600OPEN SPLENECTOMY SVC006890 14800 19300 22200 25200 28200OVARIAN CYSTECTOMY SVC006891 19100 24900 28700 32500 36300PANCREATICODUODENECTOMY (WHIPPLE'S RESECTION) SVC006892 64100 83400 96200 109000 121800PERMCATH INSERTION-ONCOLOGY SVC006893 12800 16700 19200 21800 24400PHARYNGECTOMY PARTIAL SVC006925 38200 49700 57300 65000 72600PLEURODESIS SVC006894 16100 21000 24200 27400 30600PNEUMONECTOMY SVC006895 49600 64500 74400 84400 94300RECONSTRUCT WITH FLAP - CHEST AND ABDOMINAL WALL SVC006917 42300 55000 63500 72000 80400RECONSTRUCT. WITH INTERPOL. COMPOSITE FLAP SVC006913 33900 44100 50900 57700 64500RECONSTRUCTION WITH ANATOMICAL CLOSURE SVC006919 25500 33200 38300 43400 48500

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteSALVAGE LARYNGECTOMY SVC012218 28900 37600 43400 49200 55000SALVAGE NECK DISSECTION SVC012217 30100 39200 45200 51200 57200SALVAGE ORAL CANCER RESECTION SVC012221 28900 37600 43400 49200 55000SIMPLE MASTECTOMY SVC006897 21100 27500 31700 35900 40100SIMPLE VULVECTOMY SVC006898 25800 33600 38700 43900 49100SINGLE LOBECTOMY SVC006887 45000 58500 67500 76500 85500SMALL BOWEL RESECTION ANASTOMOSIS SVC006948 46200 60100 69300 78600 87800SUPRA SELECTIVE NECK DISSECTION SVC013736 10500 13700 15800 17900 20000THYMECTOMY SVC006901 56000 72800 84000 95200 106400TONGUE COMPOSITE RESECTION/ COMMANDO SVC006923 48300 62800 72500 82200 91800

CIRCUMCISION PKG PKG004590 28000 36400 42000 47600 53200ADRENALECTOMY-B/L SVC010958 75100 97700 112700 127700 142700ANASTOMOTIC URETHEROPLASTY WITH INFERIOR PUBECTOMY SVC010967 63600 82700 95400 108200 120900ANASTOMOTIC URETHROPLASTY SVC010729 32900 42800 49400 56000 62600ANTEGRADE/RETROGRADE URETHROGRAM SVC010739 3100 3100 4100 4700 5300 5900AUGMENTATION CYSTOPLASTY SVC010831 69300 90100 104000 117900 131700AV FISTULA SVC010778 13900 18100 20900 23700 26500BILATERAL ORCHIDECTOMY PKG PKG007728 52000 67600 78000 88400 98800BILATERAL ORCHIDOPEXY SVC010682 28800 37500 43200 49000 54800BLADDER NECK INCISION SVC010685 20800 27100 31200 35400 39600BLADDER NECK SUSPENSION SVC010686 37700 49100 56600 64100 71700BLADDER WASHOUT SVC010684 4800 6300 7200 8200 9200BUCCAL URETHEROPLASTY SVC010839 56400 73400 84600 95900 107200CALIBRATION SVC010807 1100 1500 1700 1900 2100CHECK CYSTOSCOPY GA SVC010918 3100 4100 4700 5300 5900CHECK CYSTOSCOPY LA SVC010916 4100 5400 6200 7000 7800CHORDEE CORRECTION SVC010928 15100 19700 22700 25700 28700CIRCUMCISION SVC010689 11600 15100 17400 19800 22100CLOT EVACUATION SVC010966 12800 16700 19200 21800 24400

CLP/PCCL (ENDOSCOPIC CYSTOLITHOTRIPSY) STONE LESS THAN 2CMS SVC010946 18500 24100 27800 31500 35200

Urology

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CLP/PCCL (ENDOSCOPIC CYSTOLITHOTRIPSY) STONE MORE THAN 2CMS SVC010945 25700 33500 38600 43700 48900CYSTO FULGURATION SVC011059 23100 30100 34700 39300 43900CYSTOLITHOTOMY SVC010719 16900 22000 25400 28800 32200CYSTOLITHOTRIPSY + TURP SVC010780 34700 45200 52100 59000 66000CYSTOSCOPY + RGP SVC010965 16200 21100 24300 27600 30800CYSTOSCOPY AND BLADDER BIOPSY SVC010781 20800 20800 27100 31200 35400 39600CYSTOSCOPY PKG PKG004599 14800 19300 22200 25200 28200CYSTOSCOPY_02 SVC010695 9800 9800 12800 14700 16700 18700CYSTOSTOMY (OPEN) SVC010720 13100 17100 19700 22300 24900DIVERTICULECTOMY SVC010698 21200 27600 31800 36100 40300DJ STENT REMOVAL - BILATERAL SVC010902 11400 14900 17100 19400 21700DJ STENT REMOVAL PKG PKG003330 9700 12700 14600 16500 18500DJ STENTING B/L SVC010897 19100 24900 28700 32500 36300DJ STENTING UNILATERAL SVC010932 14300 18600 21500 24400 27200DORSAL SLIT SVC010700 6100 6100 8000 9200 10400 11600DRAIN/CATHETER PLACEMENT SVC010701 6200 6200 8100 9300 10600 11800ENDOSCOPIC CYSTOLITHOTRIPSY - STONE MORE THAN 2 CMS SVC010852 14400 18800 21600 24500 27400ENDOSCOPIC URETEROCOELE INCISION SVC010702 23100 30100 34700 39300 43900EPIDIDYMECTOMY UNILATERAL SVC010703 9400 9400 12300 14100 16000 17900EXTENDED PYELOLITHOTOMY SVC010786 51700 67300 77600 87900 98300FLEXIBLE CYSTOSCOPY SVC010707 7200 7200 9400 10800 12300 13700FRENULOPLASTY SVC010708 9300 9300 12100 14000 15900 17700GRAFT NEPHRECTOMY SVC010787 65800 85600 98700 111900 125100HOLEP-LARGE SVC010953 80900 105200 121400 137600 153800HYDROCOELE REPAIR BILATERAL SVC010866 19700 25700 29600 33500 37500HYDROCOELE REPAIR UNILATERAL SVC010709 11000 14300 16500 18700 20900HYPOSPADIAS REPAIR SVC010745 25500 33200 38300 43400 48500ILEAL CONDUIT DIVERSION SVC010710 42300 55000 63500 72000 80400ILEAL REPLACEMENT OF URETER SVC010790 49900 64900 74900 84900 94900ILIO INGUINAL LYMPH NODE DISSECTION-B/L SVC010943 36400 47400 54600 61900 69200ILIO INGUINAL LYMPH NODE DISSECTION-U/L SVC010942 25700 33500 38600 43700 48900

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteINTRAVESICAL BCG THERAPY SVC010812 2400 2400 3200 3600 4100 4600INTRAVESICAL BOTOX SVC010941 7200 9400 10800 12300 13700LAP URETEROLYSIS -U/L SVC010952 46200 60100 69300 78600 87800LAP VAULT PROLAPSE SURGERY SVC010960 69300 90100 104000 117900 131700LAP VVF REPAIR SVC010951 57800 75200 86700 98300 109900LAPAROSCOPIC ADRENALECTOMY-SIMPLE-B/L SVC010959 86700 112800 130100 147400 164800LAPAROSCOPIC BIOPSY SVC010714 16000 16000 20800 24000 27200 30400LAPAROSCOPIC NEPHROURETERCTOMY SVC010883 98200 127700 147300 167000 186600LAPAROSCOPIC PARTIAL NEPHRECTOMY SVC010791 57800 75200 86700 98300 109900LAPAROSCOPIC PYELOPLASTY SVC010715 48600 63200 72900 82700 92400LAPAROSCOPIC RADICAL PROSTATECTOMY SVC010736 65700 85500 98600 111700 124900LAPAROSCOPIC SIMPLE NEPHRECTOMY SVC010930 80400 104600 120600 136700 152800LAPAROSCOPIC URETERIC RE IMPLANTATION SVC010881 43700 56900 65600 74300 83100LAPAROSCOPIC URETEROLITHOTOMY SVC010716 40500 52700 60800 68900 77000LAPAROSCOPIC VARICOCOELECTOMY SVC010717 33300 43300 50000 56700 63300LASER BNI (BLADDER NECK INCISION) SVC010842 23600 30700 35400 40200 44900LASER ENDOPYELOTOMY SVC010846 32900 42800 49400 56000 62600LASER PUV FULGURATION SVC010845 28900 37600 43400 49200 55000

LASER TRANSURETHRAL RESECTION OF PROSTATE (LASER-TURP) SVC010895 44200 57500 66300 75200 84000LASER TURP LESS THAN 50 GMS SVC010840 40500 52700 60800 68900 77000LASER TURP MORE THAN 50 GMS SVC010841 63600 82700 95400 108200 120900LITHOTRIPSY SVC010906 33900 44100 50900 57700 64500MEATOPLASTY SVC010718 15100 19700 22700 25700 28700MEATOTOMY-PKG PKG007824 10400 13600 15600 17700 19800MICROSCOPIC VASOVASOSTOMY/ VASO EPIDIDYMOSTOMY SVC010803 51700 67300 77600 87900 98300MICROSURGICAL INGUINAL VARICOCELECTOMY - BILATERAL SVC010900 35000 45500 52500 59500 66500MICROSURGICAL INGUINAL VARICOCELECTOMY - UNILATERAL SVC010899 27800 36200 41700 47300 52900MULTIPLE METASTATECTOMY SVC013609 45200 58800 67800 76900 85900NEPHROLITHOTOMY SVC010776 32900 42800 49400 56000 62600NEPHROSTOGRAM SVC010816 1800 1800 2400 2700 3100 3500NEPHROSTOMY SVC010855 20700 27000 31100 35200 39400

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteNEPHROURETERECTOMY,RADICAL WITH BLADDER CUFF EXCISION, OPEN SVC010919 75100 97700 112700 127700 142700OIU SVC010944 19300 25100 29000 32900 36700OIU (CORE THROUGH) SVC010850 8400 8400 11000 12600 14300 16000OPEN SIMPLE NEPHRECTOMY SVC010929 40500 52700 60800 68900 77000ORCHIDOPEXY SVC010859 20700 27000 31100 35200 39400PARTIAL CYSTECTOMY SVC010724 27800 36200 41700 47300 52900PARTIAL NEPHRECTOMY (OPEN) SVC010722 49700 64700 74600 84500 94500PARTIAL PENECTOMY SVC010725 23100 30100 34700 39300 43900PCNL (STAGHORN) SVC010728 47100 61300 70700 80100 89500PCNL PARTIAL STAG HORN SVC010954 38200 49700 57300 65000 72600PELVIC EXENTERATION SVC010726 62800 81700 94200 106800 119400PELVIC LYMPH NODE DISSECTION SVC010792 25200 32800 37800 42900 47900PENILE IMPLANTATION SVC010938 40500 52700 60800 68900 77000PENILE STRAIGHTENING SVC010688 19100 24900 28700 32500 36300PERCUTANEOUS NEPHROLITHOTOMY (PCNL) PKG PKG004639 96300 125200 144500 163800 183000PERINEPHRIC ABSCESS DRAINAGE (OPEN) SVC010784 17100 22300 25700 29100 32500PEYRONIE'S PLAQUE EXCISION+ GRAFTING SVC010964 28900 37600 43400 49200 55000PREPUTIAL SEPARATION SVC010947 1800 2400 2700 3100 3500PRIAPISM DECOMPRESSION SVC010957 9300 12100 14000 15900 17700PROSTATECTOMY (OPEN) SVC010723 30300 39400 45500 51600 57600PYELOLITHOTOMY (OPEN) SVC010731 23400 30500 35100 39800 44500PYELOPLASTY (OPEN) SVC010732 30700 40000 46100 52200 58400RADICAL CYSTECTOMY SVC010825 66800 86900 100200 113600 127000RADICAL CYSTECTOMY AND ILEAL CONDUIT SVC010733 59900 77900 89900 101900 113900RADICAL CYSTECTOMY AND NEOBLADDER FORMATION SVC010886 90100 117200 135200 153200 171200RADICAL NEPHRECTOMY WITH IVC EXPLORATION SVC010887 52000 67600 78000 88400 98800RADICAL NEPHRECTOMY+LEVEL 2 THROMBUS IVC SVC010949 63600 82700 95400 108200 120900RADICAL NEPHRECTOMY+LEVEL 3 THROMBUS IVC SVC010950 86700 112800 130100 147400 164800RADICAL ORCHIDECTOMY SVC010939 28900 37600 43400 49200 55000RADICAL PROSTATECTOMY SVC010735 49700 64700 74600 84500 94500RENAL AUTOTRANSPLANTATION SVC010826 98200 127700 147300 167000 186600

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteREPAIR OF PENILE FRACTURE SVC010727 25500 33200 38300 43400 48500RETROGRADE INTRARENAL SURGERY ( RIRS ) - BILATERAL SVC010898 40600 52800 60900 69100 77200RETROGRADE INTRARENAL SURGERY (RIRS) SVC010797 28700 37400 43100 48800 54600RETROPERITONEAL LYMPH NODE DISSECTION (< 5 CM MASS) SVC010740 37600 48900 56400 64000 71500RETROPERITONEAL MASS EXCSION-LARGE SVC010962 63600 82700 95400 108200 120900RETROPERITONEAL MASS EXCSION-MEDIUM SVC010961 40500 52700 60800 68900 77000RIRS-COMPLEX SVC010963 57800 75200 86700 98300 109900SCROTAL DEBRIDEMENT U/L SVC010956 28900 37600 43400 49200 55000SCROTAL EXPLORATION SVC011054 26600 34600 39900 45300 50600SPC INSERTION SVC010806 8700 8700 11400 13100 14800 16600SUBCAPSULAR ORCHIDECTOMY SVC010743 18500 24100 27800 31500 35200SUBSTITUTION URETHROPLASTY (FULL LENGTH) SVC010935 63600 82700 95400 108200 120900SUBSTITUTION URETHROPLASTY (NOT FULL LENGTH) SVC010744 51700 67300 77600 87900 98300SUBSTITUTION URETHROPLASTY (STAGE 1) SVC010936 29800 38800 44700 50700 56700SUBSTITUTION URETHROPLASTY (STAGE 2) SVC010937 40500 52700 60800 68900 77000TESTICULAR BIOPSY SVC010746 6600 6600 8600 9900 11300 12600TESTIS IMPLANT SVC012995 15800 20600 23700 26900 30100TOTAL PENECTOMY SVC010747 24400 31800 36600 41500 46400TOTAL PENECTOMY AND URETHROSTOMY SVC010798 39300 51100 59000 66900 74700TRANS OBTURATOR/ TRANS VAGINAL TAPE INSERTION SVC010796 46200 60100 69300 78600 87800TRANSPUBIC URETHROPLASTY SVC010748 47100 61300 70700 80100 89500TRANSRECTAL PROSTATE BIOPSY SVC010749 5900 5900 7700 8900 10100 11300TRANSURETHRAL RESECTION OF BLADDER TUMOUR (TURBT) - TUMOR MORE THAN 2 CMS SVC010851 39300 51100 59000 66900 74700TRANSURETHRAL RESECTION OF PROSTATE (TURP) PKG PKG004701 91500 119000 137300 155600 173900TRANSURETHRAL RESECTION OF PROSTATE < 40 GM SVC010772 39800 51800 59700 67700 75700TRANURETHRAL RESECTION IN SALINE SVC010955 63600 82700 95400 108200 120900TUBE EXCHANGE SVC010751 600 600 800 900 1100 1200TURBT TUMOR LESS THAN 2CMS SVC010940 22000 28600 33000 37400 41800URETERIC CATHETERIZATION SVC010911 2600 3400 3900 4500 5000LAP. NEPHRECTOMY RADICAL SVC000861 49670 64580 74550 84530 94400URETERIC REIMPLANTATION SVC010753 39300 51100 59000 66900 74700

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Servie Name Service Code OPD General Semi Private Private Suite Deluxe SuiteURETEROCALICOSTOMY SVC010915 46200 60100 69300 78600 87800URETEROLITHOTOMY (OPEN) SVC010755 23000 29900 34500 39100 43700URETEROSCOPIC STONE REMOVAL SVC010801 27800 36200 41700 47300 52900URETEROURETEROSTOMY SVC010761 40500 52700 60800 68900 77000URETHRAL DILATATION SVC010759 8400 8400 11000 12600 14300 16000URETHRAL STRICTURE REPAIR SVC010810 11600 15100 17400 19800 22100URETHROPLASTY SVC010762 28500 37100 42800 48500 54200URETHROSTOMY PERINEAL SVC010912 26700 34800 40100 45400 50800URETIC DIALATATION SVC013141 10500 13700 15800 17900 20000URODYNAMICS SVC010764 7600 7600 9900 11400 13000 14500UROFLOWMETRY SVC010765 1200 1200 1600 1800 2100 2300URS SVC010838 20800 27100 31200 35400 39600URS B/L SVC010913 33000 42900 49500 56100 62700VARICOCOELECTOMY (OPEN) SVC010766 14400 18800 21600 24500 27400VASECTOMY SVC010767 8600 8600 11200 12900 14700 16400

VESICO VAGINAL FISTULA REPAIR/ URETERO VAGINA FISTULA REPAIR SVC010690 30700 40000 46100 52200 58400VESICOSTOMY SVC010768 12500 16300 18800 21300 23800VESICOSTOMY CLOSURE SVC010769 9600 9600 12500 14400 16400 18300WEDGE BIOPSY SVC010770 3200 3200 4200 4800 5500 6100

ABOVE KNEE AMPUTATION SVC011128 38300 49800 57500 65200 72800AORTIC STENTING SVC011075 63600 82700 95400 108200 120900AV FISTULA PKG PKG003111 20800 27100 31200 35400 39600A-V GRAFT SVC011106 52500 68300 78800 89300 99800BELOW ELBOW AMPUTATION - U/L SVC011163 8700 11400 13100 14800 16600BELOW KNEE AMPUTATION SVC011127 38300 49800 57500 65200 72800EMBOLECTOMY - FEMORAL SVC011146 42000 54600 63000 71400 79800

ENDOVENOUS LASER TREATMENT OF VARICOSE VEINS UNILATERAL SVC011107 50400 65600 75600 85700 95800FEMORO-POPLITEAL BYPASS ABOVE KNEE SVC011082 9300 12100 14000 15900 17700HICKMANS CATHETER INSERTION SVC011138 21000 27300 31500 35700 39900

Vascular Surgery

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INJECTION SCLEROTHERAPY OF VARICOSE VEINS WITH US SCAN SVC011110 21000 27300 31500 35700 39900IVC FILTER PLACEMENT SVC011113 42000 54600 63000 71400 79800OPEN SURGERY FOR VARICOSE VEINS SVC011108 31500 41000 47300 53600 59900PERIPHERAL ANGIOPLASTY SVC011140 42000 54600 63000 71400 79800PERMACATH/ PORTACATH PLACEMENT SVC011124 55300 71900 83000 94100 105100PERMACATH/ PORTACATH REMOVAL SVC011125 4800 6300 7200 8200 9200PERMCATH INSERTION SVC011061 9300 12100 14000 15900 17700PTA (PERIPHERAL ANGIOPLASTY) SVC011154 41600 54100 62400 70800 79100RADIO-CEPHALIC FISTULA SVC011096 26300 34200 39500 44800 50000TOE AMPUTATION SVC011130 15300 19900 23000 26100 29100TIPSS SVC011116 55000 71500 82500 93500 104500

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schedule of charges - narayana health

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