LaboratoryRadiologyDentalOperating / Delivery RoomsAmbulanceRoomsBlood BankMiscellaneous
LABORATORY FEES AND CHARGES
Services PhPesos
Actual Platelet Count 40.00
AFB (Other Body Fluids) 100.00
Albumin 250.00
Alkaline Phosphatase 350.00
Amylase 350.00
Anti-HBe 1,500.00
Anti – HBs 700.00
Anti-HCG 550.00
Anti-Hepatitis B Surface (Anti-HBs) 700.00
APTT 600.00
ASO (Anti-Streptolysis O) 150.00
Autocontrol 250.00
Autopsy 10,000.00
B1B2 400.00
Beta-HCG(Human Chorionic Gonadotrophin) 550.00
BHCG 550.00
Bile Determination 30.00
Biopsy (Level 1) 200.00
Biopsy (Level 2) 300.00
Biopsy (Level 3) 400.00
Biopsy (Level 4) 500.00
Biopsy (Level 5) 600.00
Biopsy (Level 6) 700.00
Blood Agar Plate 80.00
Blood Bag Double 200.00
Blood Bag Single 100.00
Blood Bag Triple 300.00
Blood Culture and Sensitivity 1,650.00
Blood Typing ABO 100.00
Blood Typing of Mother 60.00
Blood Typing with Rh Typing 150.00
Blue Top 25.00
BNP (Quantitative Test) 800.00
BSMP 50.00
BSMP Strip 150.00
BUA (Blood Uric Acid) 150.00
BUN 150.00
CA 125 1,500.00
CA 153 1,500.00
Cadavers Storage Fee 1,000.00
Calcium Chemistry 150.00
Calcium Ion 220.00
Calcium Serum 350.00
CBC 175.00
CBC W/ APC 200.00
CEA 1,500.00
Cell Block/Slide 100.00
Cell Block 400.00
Chem 8 1,330.00
Chem 10 1,730.00
Chloride (Cl) 220.00
Cholesterol 150.00
CKMB 300.00
Clotting Time, Bleeding Time 75.00
Creatinine 150.00
Crossmatching 500.00
Crossmatching (Auto Control) 400.00
CRP 800.00
CSF and Other Body Fluids 600.00
Culture and Sensitivity – Blood 1,650.00
Culture and Sensitivity – CSF 1,200.00
Culture and Sensitivity (Pleural Fluid) 1,200.00
Culture and Sensitivity (Sputum) 1,200.00
Culture and Sensitivity – Urine 1,350.00
Culture and Sensitivity (Wound Discharge) 1,200.00
DAT (Direct Anti Globulin Test) 250.00
Dengueline 700.00
Direct Bilirubin 250.00
Direct Coombs Test 200.00
Drug Testing 250.00
ESR (Erythocyte Sedimentation Rate) 150.00
FBS (Fasting Blood Sugar) 150.00
FFP 900.00
FNAB/Cytology 250.00
Fine Needle Aspiration Smears/Slide 50.00
Fine Needle Aspiration Biopsy 250.00
Fluid Analysis 600.00
Frozen Section(Large Definitive) 1,300.00
Frozen Section(Small Definitive) 1,000.00
FT4 550.00
Globulin 150.00
Handling Fee 1,500.00
HBA1C 875.00
HBC 600.00
HBe 1,500.00
HBeAg 1,500.00
HBsAg 150.00
HBsAg – MEIA 450.00
HCV ELISA 460.00
HCV PA 450.00
HDL (High Density Lipoprotein) 250.00
Hemoglobin + Hematocrit 100.00
Histopath Blocks (Handling Fee) 200.00
Histopath Slide (Handling Fee) 50.00
HIV ELISA 450.00
HIV PA 350.00
Gram Staining 100.00
Indirect Bilirubin 150.00
Kidney UTZ 310.00
KOH 100.00
Lavender Top 20.00
LDL 150.00
Leptospira Screening Test 700.00
Lipid Profile 730.00
Magnesium 350.00
NS1 Ag 1,000.00
Occult Blood 75.00
OGTT 300.00
PAPS (PAP Smear)/Slide 50.00
PAP Smear 120.00
PBS (Peripheral Blood Smear) 200.00
Phosphorus 350.00
Platelet Concentrate (No Donor) 900.00
Platelet Concentrate (With Donor) 900.00
Pleural Fluid Analysis 600.00
Potassium (K) 220.00
PRBC 1,100.00
Pregnancy Test (Preg Test) 150.00
Prostate Specific Antigen 1,300.00
PT (Prothrombin Time) 500.00
PT with INR 600.00
PTT (Partial Prothrombine Time) 600.00
RBS 150.00
Red Top / EDTA 20.00
Reticulocyte Count 150.00
Rh Typing 60.00
Routine Fecalysis 100.00
Routine Fecalysis Concentration Technique 150.00
Routine Urinalysis 150.00
Routine Urinalysis 4 Parameter 150.00
Routine Urinalysis Flow Cytometer with 4 Parameter 150.00
Routine Urinalysis 10 Parameter 125.00
Routine Urinalysis Flow Cytometer with 10 Parameter 175.00
RPR (Rapid-Plasma Regin)/VDRL 100.00
Screening Fee 1,500.00
Screening Fees (PRBC) 1,100.00
Screening Fee (WB) 1,700.00
SGOT (Serum Glutamic Oxaloacetic Transaminase) 200.00
SGPT (Serum glutamic Pyruvate Transaminase) 200.00
SODIUM (Na) 220.00
Sodium Potassium Chloride 660.00
Specific Blood Typing (FFP/ PC) 60.00
Sperm Analysis 300.00
S. Typhi/Typhidot 700.00
Surgical Pathology Level I (Gross Exam Only) – Processing Fee 200.00
Surgical Pathology Level II) (Norma/Incidental) – Processing Fee 300.00
Surgical Pathology Level III (Small) – Processing Fee 400.00
Surgical Pathology Level IV (Medium) – Processing Fee 500.00
Surgical Pathology Level V (Large) – Processing Fee 600.00
Surgical Pathology Level VI (Extra Large) – Processing Fee 700.00
Surgical Specimen/Slide 100.00
T3/FT3 550.00
T4/FT4 550.00
Test Tube – EDPA/Red Tab 25.00
Total Bilirubin 250.00
Total Cholesterol 150.00
Total Protein 250.00
TPPA 200.00
Triglyceride 180.00
Troponin(Qualitative) I 450.00
Troponin(Quantitave) I 800.00
Troponin(Qualitative) T 650.00
Troponin(Quantitative) T 800.00
TSH 550.00
Typhi Dot 700.00
Urine 10 Parameters 100.00
Urine Culture and Sensitivity 1,350.00
Urine Ketones 25.00
Urine RBC Morphology 100.00
WBC Diff. Count 25.00
RADIOLOGY FEES AND CHARGES
Services PhPesos
1 Breast – UTZ 380.00
2 Breast – UTZ 550.00
Abdomen AP, Translateral (Pedia) 210.00
Abdomen Decubitus (Left) 180.00
Abdomen Decubitus (Right) 180.00
Abdomen Lateral 200.00
Abdomen Supine 180.00
Ankle Joint APL (Left) 120.00
Ankle Joint APL (Right) 120.00
Ankle Mortise (Left) 120.00
Ankle Mortise (Right) 120.00
Apicogram (Lordotic View) 120.00
Baby Gram 200.00
Barium Enema 1,000.00
Barium Swallow 500.00
Biophysical Scoring (BPS) – UTZ 520.00
Cald Well 150.00
Cardiac Series 350.00
C-ARM (Charity) 850.00
C-ARM (Philhealth/ Pay) 1,200.00
Cervical Spine APL 210.00
Cervico-Thoracic 370.00
Chest APL (Adult) 300.00
Chest APL (Pedia) 210.00
Chest Decubitus (Left) 180.00
Chest Decubitus (Right) 180.00
Chest Pedia (1 view) 150.00
Chest – UTZ 380.00
Cholangiogram 600.00
Clavicle AP (Left) 120.00
Clavicle AP (Right) 120.00
Cranial – UTZ 450.00
Cystogram 600.00
Distal Colonogram 500.00
ECG 175.00
Elastogram 50.00
Elbow Joint APL (Left) 120.00
Elbow Joint APL (Right) 120.00
Esophagography/Barium Swallow 800.00
Facial Bones 120.00
FAST – UTZ 480.00
Femur APL (Left) 200.00
Femur APL (Right) 200.00
Fetal Aging – UTZ 450.00
Fistulogram 500.00
Fluoro-Guided 500.00
Foot APO (Left) 120.00
Foot Apol 180.00
Foot APO (Right) 120.00
Forearm APL (Left) 200.00
Forearm APL (Right) 200.00
Hand APO (Left) 120.00
Hand APO (Right) 120.00
HBT – UTZ 420.00
Heel Bone – Axial / Lateral 100.00
Hip Joint (Left) 150.00
Hip Joint (Right) 150.00
HUMERUS APL (Left) 200.00
HUMERUS APL (Right) 200.00
Hysterosalpingography 800.00
Inguino-Scrotal 315.00
Knee Joint APL (Left) 150.00
Knee Joint APL (Right) 150.00
KUB and Prostate – UTZ 420.00
KUB (IVP) 1,000.00
KUB (kidneys and urinary bladder) – UTZ 420.00
KUB (Plainabd) – x-ray 150.00
Leg APL (Left) 200.00
Leg APL (Right) 200.00
Lower Abd 480.00
Lower Abdomen – UTZ 560.00
Lumbar Vertebrae (2 views) 270.00
Lumbosacral APL 300.00
Mandible 3 Views – FILM 320.00
Mastoids (R/L) (FILM) 280.00
Maxilla Mandible 2 Views 280.00
Mobile X-Ray 1 or 2 View (Charity) 150.00
Mobile X-Ray 1 or 2 Views (PHIC/Pay) 200.00
Mobile X-Ray More than 2 Views (Charity) 300.00
Mobile X-Ray More than 2 Views (PHIC/Pay Patients) 350.00
Nasal Bones (Waters/STL) 200.00
Optic Foramen (R/L) 300.00
Orbit 2 views 200.00
Oscalsis APL (Left) 120.00
Oscalsis APL (Right) 120.00
Pelvic – UTZ 420.00
Pelvis AP 180.00
Plain Abdomen(supine & upright) 300.00
PNS lat/ waters/ Caldwells 330.00
Procedure IVP 1,000.00
Retrograde Pyelography 800.00
Retrograde Pyelography (RGP) 800.00
Sacrum / Coccyx APL 210.00
SCAPULA AP (Left) 120.00
SCAPULA AP (Right) 120.00
Scapular Left Y 170.00
Scapular Right Y 170.00
Scoliatic Series 350.00
Shoulder Joint AP (Left) 120.00
Shoulder Joint  AP (Right) 120.00
Single Organ – UTZ 280.00
Skull APL 200.00
Small Intestines Series 800.00
SMV 330.00
Soft Tissue Lateral (STL) 120.00
Submental – UTZ 350.00
Temporo-Mandibular Bone (Open, Close, Bilat) 350.00
Thoracic APL 330.00
Thoracic Cage AP 180.00
Thoraco – Lumbar APL 380.00
Thoraco – Lumbosacral APL 550.00
Thyroid – UTZ 490.00
Thyroid w/ Elastogram – UTZ 400.00
Townes 150.00
Transabdomen (Pelvis) – UTZ 350.00
Transrectal / Prostate – UTZ 500.00
Transrectal – UTZ 490.00
Transvaginal – UTZ 490.00
Ultrasound Guided Procedures (OPD) – UTZ 250.00
Ultrasound Guided Procedures (PAY) – UTZ 250.00
Upper Abdomen – UTZ 560.00
UPPER GI SERIES 1,000.00
Waters View 150.00
Whole Abdomen – UTZ 650.00
Wrist APL (Left) 120.00
Wrist APL (Right) 120.00
Zygoma(SMV) – FILM 180.00
Ct Scan-Cervical Spine (Contrast) w/o PF 3,700.00
Ct Scan-Cervical Spine (Plain) w/o PF 3,100.00
Ct Scan-Chest (High Resolution) w/o PF 3,375.00
Ct Scan-Chest (Routine) w/o PF 3,375.00
Ct Scan-Cranial (Contrast) w/o PF 2,500.00
Ct Scan-Cranial (Plain) w/o PF 2,500.00
Ct Scan-Ct Guided Biopsy w/o PF 6,000.00
Ct Scan-Lower/Upper Abdomen (Routine) w/o PF 3,225.00
Ct Scan-Lumbar Spine (Contrast) w/o PF 3,700.00
Ct Scan-Lumbar Spine w/o PF 3,700.00
Ct Scan-Nasopharynx/Osopharynx (Coronal And Axial Cuts) w/o PF 4,000.00
Ct Scan-Orbit Scan w/o PF 4,000.00
Ct Scan-Paranasal Sinuses (Coronal And Axial Cuts) w/o PF 4,000.00
Ct Scan-Pelvis w/o PF 3,700.00
Ct Scan-Pituitary Fossa (Plain) w/o PF 2,775.00
Ct Scan-Sella Turcica W/Contrast  w/o PF 2,775.00
Ct Scan-Stonogram w/o PF 4,700.00
Ct Scan-Temporal Bone (Contrast) w/o PF 4,050.00
Ct Scan-Temporal Bone (Plain) w/o PF 4,050.00
Ct Scan-Temporo Mandibular Joint (Plain) w/o PF 2,775.00
Ct Scan-Thoracic Spine (Contrast) w/o PF 3,900.00
Ct Scan-Thoracic Spine w/o PF 3,900.00
Ct Scan-Triple Phase Contrast Study For Liver w/o PF 6,000.00
Ct Scan-Triple Phase Contrast Study For Liver w/o PF w/ Power Injector Syringe 100ml 6,960.00
Ct Scan-Whole Abdomen w/o PF 5,025.00
Ct Scan-Cervical Spine (Contrast) w/o PF 3,700.00
Ct-Scan-Facial 4,700.00
DENTAL RATES
Services PhPesos
Alveolectomy (Full) 8,260.00
Dental X-Ray 200.00
Gingivectory 8,020.00
Glassionomer 165.00
Gum Treatment 250.00
Incision and Drainage 8,260.00
Light Cured Composite 275.00
Odontectomy (Impaction) 1,500.00
Operculectomy (Pericoronitis) 300.00
Oral Prophylaxis (Cleaning) 275.00
Pit and Fissure Sealant Application 275.00
Reduction and Fixation of Fractured mandible and maxilla (Risdon Wiring) 1,300.00
Temporary Filling 110.00
Tooth Extraction (Ordinary) 100.00
OPERATING / DELIVERY ROOM RATES
Room Rate PhPesos
Operating Room/Delivery Room Fee RUV 1-10 (Charity) 450.00
Operating Room/Delivery Room Fee RUV 11-20 (Charity) 630.00
Operating Room/Delivery Room Fee RUV 11-20 (Pay) 800.00
Operating Room/Delivery Room Fee RUV 21-30 (Charity) 810.00
Operating Room/Delivery Room Fee RUV 21-30 (Pay) 1,378.00
Operating Room/Delivery Room Fee RUV 30 and Below (Phic) 1,200.00
Operating Room/Delivery Room Fee RUV 31-80 (Charity) 1,215.00
Operating Room/Delivery Room Fee RUV 31-80 (Pay) 1,755.00
Operating Room/Delivery Room Fee RUV 31 to 80 (Phic) 1,500.00
Operating Room/Delivery Room Fee RUV 81-600 (Phic) 3,500.00
Operating Room/Delivery Room Fee RUV 81+ (Charity) 3,141.00
Operating Room/Delivery Room Fee RUV 81+ (Pay) 4,253.00
Operating Room/Delivery Room RUV 1-10 (Pay) 500.00
AMBULANCE RATES
Services PhPesos
Ambulance(2-D Echo Bay.-Sol.) 500.00
Ambulance(C.T. Scan Bay.-Sol) 300.00
Ambulance(C.T. Scan PLT) 500.00
Ambulance(Dialysis – Bambang) 800.00
Ambulance(Dialysis Bonfal) 300.00
Ambulance(Dialysis Solano) 500.00
Ambulance(UTZ-EEG Bay.-Sol.) 500.00
Ambulance(UTZ VRH-PLT Hosp.) 700.00
Ambulance(VRH to A. Castaneda) 4,600.00
Ambulance(VRH to Ambaguio) 550.00
Ambulance(VRH to Aritao) 850.00
Ambulance(VRH to Bagabag) 750.00
Ambulance(VRH to Baguio) 7,500.00
Ambulance(VRH to Bambang) 400.00
Ambulance(VRH to Bayombong) 75.00
Ambulance(VRH to Diadi) 1,400.00
Ambulance(VRH to Dupax d.Norte 700.00
Ambulance(VRH to Dupax d.Sur) 800.00
Ambulance(VRH to Kasibu) 1,350.00
Ambulance(VRH to Kayapa) 1,500.00
Ambulance(VRH to Manila) 7,500.00
Ambulance(VRH to Quezon) 550.00
Ambulance(VRH to Santiago) 1,700.00
Ambulance(VRH to Sta. Fe) 1,450.00
Ambulance(VRH to Tuguegarao) 7,500.00
Ambulance(VRH to Villaverde) 500.00
ROOM RATES
Room and Ward PhPesos
Service Ward 500.00
PhilHealth Ward 500.00
Semi-Pay 1,100.00
Single Room 2,000.00
Suite Room 3,000.00
ICUs 2,000.00
BLOOD BANK FEES AND CHARGES
Fees and Charges PhPesos
Fresh Frozen Plasma 900.00
Fresh Whole Blood 1,500.00
Packed RBC 1,400.00
Platelet Concentrate (with donor) 900.00
Platelet Concentrate (without donor) 1,000.00
Processing Fee (blood bank) 200.00
Triple Blood Bag 300.00
Whole Blood 1,500.00
MISCELLANEOUS FEES AND CHARGES
Fees and Charges PhPesos
Anesthesia Machine 150.00
Basic IVT 3,000.00
Oxygen (per Liter) 0.25
Biometric Scanning With Paper 200.00
Birth Certificate 20.00
Cardiac Monitor 100.00
Cautery Fee 300.00
Cellphone Charge 5.00
Certificate 50.00
Certificate of Confinement 20.00
Certificate of Employment 50.00
Certification Fee 20.00
Circumcision 600.00
Clinical Abstract 50.00
Consultation Fee 200.00
 Consultation Fee (New Pt. OPD) 100.00
Consultation Fee (New Senior Citizen) 80.00
Consultation Fee (Old Pt. OPD) 50.00
Consultation Fee – Penadur 20.00
Consultation Fee (Senior Citizen) 40.00
 Dental Fee 150.00
 Desk Fan 15.00
 Discharge Summary 20.00
 Dressing 50.00
 Droplight/Isollete 100.00
 Electric Airpot 100.00
ER Consultation Fee 300.00
Examination Fee (Nursing) 100.00
Hearing Test 200.00
Incision and Drainage 120.00
 Incubator 100.00
Insurance Fee 50.00
IV Training 3,000.00
IVT Training 3,000.00
Laptop Computer/DVD Player 100.00
Lost OPD Card 100.00
Lost OPD Card (Sr. Citizen) 45.00
Mechanical Ventiltor 100.00
Medical Certificate 20.00
Medico-Legal Certificate 50.00
 Minor Fee 300.00
NCP 1,200.00
Nebulization Fee 20.00
Negatoscope 5.00
Neuro Psychiatric Examination 500.00
Newborn Care 500.00
New Born Care Package 1,200.00
Newborn Screening Package 1,100.00
Non Stress Test (NST) 200.00
Non Stress Test (Repeat NST) 100.00
 OPD Card (NEW) 50.00
OPD CARD (Re-NEW) 30.00
OR Records 20.00
Ozonation 120.00
Papsmear 120.00
Patient ID (Lost) 50.00
Phototherapy 100.00
PT w/ Modality & Exercise 200.00
PT w/o Modality(Pure Exercise) 150.00
Pulse Oximeter 10.00
 Qualifying Fee 100.00
 Removal of Cast 50.00
 Removal of Sutures 50.00
 Rice Cooker 50.00
 ROS – Removal of Sutures 50.00
 Scanning 50.00
Stand Fan 30.00
Statement of Account 20.00
Suction Machine Use 50.00
Surgical Memo 20.00
Table Rental 50.00
Thermos 100.00
Use of Scope 500.00
Utility Fee 1,500.00
Watchers ID 50.00
Xerox Fee 10.00