Page 1
1 | P a g e
CODE PROFILE COMPONENTS COST
ADPR
Adrenal
ACTH, Cortisol (am & pm) & HGH
$1500
AMPR Amenorrhoea Profile LH, FSH, Prolactin & Oestradiol $550
ANPRB Anaemia Profile(A)
FBC, ESR, IRON, TIBC, & Reticulocytes Count $350
ANDP Andropause Profile
DHEAs, FSH,LH, SHBG &Testosterone $1150
ANPRB Anemia (B) FBC,ESR, Iron & TIBC, Folate(RBC), Vitamin B-12 (fasting)& Ferritin
$1100
ANTE Antenatal Profile
FBC, Group, SCT, VDRL, FBS, FT4, TSH, Rubella IgG, Toxoplasma IgG &IgM, HCV Ab IgG &IgM, Varicella Zoster IgG, HIV 1&11 , 4th Generation + p24 Ag & Hep Bs Ag
$1900
APAB Antiphosholipid Lupus Anticoagulant, Anticardiolipin Antibodies IgA, IgG&IgM
$850
PHOSPP2
Antiphosholipid2
Lupus Anticoagulant, Anticardiolipin Antibodies IgA, IgG&IgM, B2 GlycoProtein IgG/IgM
$1350
APS
ATYPICAL PNEUMONIA SCREEN
Anti Mycoplasma IgG&IgM, Chlamydia IgG&IgM & Anti Legionella IgG&IgM
$1755
AUTOIA Auto Immune 1 Anti DNA, ANF & C3 $460
AUTOIB Auto Immune 2 ANF, C3 & Rh Factor $400
AUTOIC Auto Immune 3 Anti-DNA, ANF, ENA5, & Rh Factor $900
BMP Basic Metabolic profile
Creatinine, RBS, BUN, Electrolytes, Bicarbonate& Calcium
$400
BONESC BONE SCREEN
24hr Urinary Calcium, 24hr Urinary Phosphate, Urea, Electrolytes, Alkaline Phosphatase, Protein & Calcium
$690
CAMET Calcium Metabolism
Calcium, Creatinine, Magnesium, Phosphorus & Parathyroid Hormone(fasting)
$620
OAENZ Cardiac Enzymes
SGOT, CPK Total, LDH, Troponin $360
CARMY
Cardiac Myocardiac Infraction
CPK,CK-MB, Myoglobin&Troponin 1 $550
CARDPR
Cardiac Profile
Cardiac Myocardic Profile,CRP, Homocysteine& Fibrinogen
$1300
CPP CHEST PAIN
PROFILE Myoglobin, CK-MB Fraction, Troponin 1 $450
Page 2
2 | P a g e
CODE PROFILE COMPONENTS COST
Chikun Chikungunya Profile
Chikungunya IgG & IgM
$400
COAG Coagulation Profile
Factor V Leiden, Protein C & S, Free Protein S,Anti Thrombin 111
$3400
COAG1
Coagulation Profile 1
PT & PTT $200
COAG2
Coagulation Profile 2
FBC, PT & PTT $270
PROP
Coagulation 3 Thrombotic Risk/Miscarriage Profile
FBC, PT, PTT, Antithrombin III, Factor V Leiden, Fibrinogen, Lupus Anticoagulant, Protein C & S ,Anticardiolipin Abs,B2 Glyco Protein IgG,IgM
$4000
CMP Complete Metabolic Panel
Fasting Glucose,BUN, Creatinine, Electrolytes,Calcium, Proteins, Alkaline Phosphatase, Microalbumin, Bilirubin & SGOT
$730
FCOMP
Comprehensive Screen (Female)
FBC ESR, Blood Group, VDRL, Lipid Profile,Uric acid,Liver Function Profile 1,Urinalysis, Urea, Stool OBR(FIT), HIV,&Pap Smear
$1200
FCOMPM
Comprehensive Screen (Male)
FBC ESR, Blood Group, VDRL, Lipid Profile, Uric acid, Liver Profile 1, Urinalysis, Urea, Stool OBR(FIT), HIV& PSA
$1280
CTS1 Connective Tissue Screen
ANF, DNA& ENA (18 Anitgens) $1130
DAI1 Diabetes (1) Fasting Glucose, Glucose 2 hr PP with 75gms glucose Glycohaemoglobin & Microalbumin
$300
DIA2 Diabetes (2) Fasting Glucose, Glycohaemoglobin & Insulin $320
ELECTA Electrolytes Panel 1
Sodium, Potassium &Chloride $140
ELECTB Electrolytes Panel 2
Electrolytes Panel 1 & Bicarbonate $180
ELECTC Electrolytes Panel 3
Electrolytes Panel 2 , Calcium & Proteins $310
ENA5 ENA5 (18 Antigens)
nRNP/Sm, Sm, RNP70, RNPA, RNPC, SS-A, Ro-52, SS-B, Scl70, PM-Scl, Jo-1, CENPB, PCNA, dsDNA, Nucleosomes, Histones, Rib. P-prot., AMA-M3
$750
IMPO
Erectile Dysfunction / Impotence Profile
Lipid Profile, HbA1C, TSH, Prolactin, Total Testosterone, Free Testosterone &PSA
$1100
FEXPR Executive Profile (Female)
Comprehensive Screen(female), Cardiac Enzymes, Renal Profile &Thyroid Profile 3
$2000
MEXPR Executive Profile (Male)
Comprehensive Screen(Male), Cardiac Enzymes, Renal Profile &Thyroid Profile 3
$2300
Page 3
3 | P a g e
CODE PROFILE COMPONENTS COST
INFF Female Infertility Profile
LH, FSH, Prolactin, Oestradiol $500
INFF Female Infertility Profile
LH, FSH, Prolactin, Oestradiol $500
GLUINS Glucose/Insulin Response
6 Specimen Glucose Tolerance Test & 6 Specimen Insulin
$1250
GSA
Gluten Sensitivity Evaluation/ Celiac disease Profile
Endomysial Abs IgA Anti Gliadin IgA & lgG, Anti Tissue Transglutaminase IgA & Immunoglobulin A
$1960
HEP Hepatitis Profile HAV IgG &IgM, HbsAg, HbsAb, HCV IgG&IgM, HbeAg, HbeAb & Hbc IgG, Hbc IgM
$2400
HERPR Herpes Profile HSV 1 &11 IgG &IgM $560
HIRS Hirsutism Profile
FSH, LH, Testosterone, DHEAs & SHBG $1200
HORL HORL HBA1C, Lipid profile, Creatinine, Urea, Liver Function Profile1, HIV, GGTP& Urinalysis
$1000
HRT HRT Profile 1 FSH, Oestradiol, Progesterone $400
HRT2 HRT Profile 2 Lipid Profile, FT4, TSH, FSH, Oestradiol $650
IGS Immunoglobin IgA, IgG & IgM $460
ITA Insulin Tolerance
3 Specimen $500
ITB Insulin Tolerance
6 Specimen $1100
ISP Iron Status Profile
Iron, TIBC & Ferritin $425
LIP Lipid Profile Cholesterol,Triglycerides, HDL,VLDL, LDL, Risk Factor & Glucose Fasting
$200
LFT1 Liver Function Profile 1
Total Proteins, Alkaline Phosphatase, SGOT, SGPT, Bilirubin & GGTP
$340
LFTSB Liver Function Profile 2
Liver Function Profile 1, Cholesterol, LDH, Prothrombin Time, Protein EP
$800
INFM1 Male Infertility Profile 1
FSH, LH, SHBG, Testosterone & Prolactin $920
INFM2 Male Infertility Profile 2
Male Infertility Profile 1 & Semenology $1020
MENO Menopause Profile
FSH, LH, Oestradiol, TSH & FT4 $600
METS
Metabolic Syndrome Profile
Lipid Profile,HbA1C, Insulin, CRP& hsCRP $700
MYOS Myositis Profile M1 2 ,KU, PM-Scl, Jo-1, PL7, PL12, Ro 52 $950
Page 4
4 | P a g e
CODE PROFILE COMPONENTS COST
NVIR Neurological Viral Screen
Influenza A IgG, Measles IgG&IgM, Mumps IgG&IgM, CMV IgG &IgM,Herpes Profile, Varicella Zoster IgG &IgM &Mycoplasma IgG&IgM
$3400
Neuronal Antigens Profile
Amphiphsin,PNMA2,Ri,Yo,Hu $900
NTHYAB New Thyroid Antibodies
Thyroid Antibodies(A) & TSI $1700
OVF Ovarian Function
Estradiol, LH, FSH & Prolactin $530
PIT Pituitary Function Profile
TSH, LH, FSH, Prolactin, Human Growth Hormone & Cortisol am
$1200
PCOP
Polycystic Ovary Syndrome Profile
Testosterone, TSH,FSH, DHEAs, Insulin, LH, Lipid Profile, Prolactin, Androstenedione & SHBG
$3100
PRENAA Prenatal 1. CBC, Group, VDRL & HIV 1&11, 4th Generation & P24 Ag
$300
PRENAB Prenatal 2. Prenatal 1 & Rubella IgG $370
PRENAC Prenatal 3. Prenatal 1, RBS & Haemoglobin Electrophoresis (SCT) Quantification
$600
PRENAD Prenatal 4. Prenatal 2 & Haemoglobin Electrophoresis (SCT) Quantification
$620
PTS Pre-Travel Screen (DVT)
FBC, Factor V Leiden& Anticardiolipin Abs $1250
PROPSA Prostate Health Index
Pro PSA, Free PSA, Total PSA $650
Protein Ep Profile
Protein Electrophoresis ,Free K+L Lt Chain Qn Serum, Total K+L Lt Chain ,Immunoglobulin A,G and M,Immunofiaxtion
$8000
Protein Electrophoresis with Immunofixation $1500
APA Pernicious Anemia profile
Anti PCA Parietal Cell Ag Gastric parietal & Anti Intrinsic Factor
$1500
RFTS Renal Profile BUN, Creatinine, Uric Acid, Electrolytes Panel 1, Iron &Proteins
$380
RFTB Basic Renal Profile
BUN, Creatinine &Electrolytes Panel 1 $250
RHPR1
Rheumatology Prof 1
FBCESR, Uric Acid, Rheumatoid Factor, Anti-CCP Ab (RF) &CRP
$580
RHPR2
Rheumatology Prof 3 Disease
Rheumatology Prof 1 & ANF
$700
RHPR3
Rheumatology Prof 2 (General screen for connective tissue disorders)
Rheumatology Prof 1,ANF, DNA & ENA (18 Antigens)
$1400
Page 5
5 | P a g e
CODE PROFILE COMPONENTS COST
RHPR4
Rheumatology Prof 4 Systematic lupus Erythematosus
FBCESR, ANF, ENA 5 (18 Antigens), Rheumatoid Factor, Anti-CCP Ab, Anticardiolipin Abs, C3, C4,& CRP
$2000
RHPR6
Rheumatology Prof 6 Rheumatoid Factor
Rheumatoid Factor, Anti-CCP Ab &CRP $400
RHPR
7
Rheumatology Prof 7 Sjrogren's Syndrome
ENA5 (18 Antigens) &CRP $850
SMA12 SMAC 12
Glucose, Protein, SGOT(AST), Bilirubin, Electrolytes Panel 1, Uric Acid, Calcium, Phosphorus, Alkaline Phosphatase, BUN, Creatinine, CPK, LDH & Cholesterol
$1000
SMAC 20 SMAC 20
Liver Function Profile 1, Lipid profile, Electrolytes Panel 1, Uric Acid, Calcium, Phosphorus, BUN, Creatinine,LDH & GGTP
$1100
SMAC 25 SMAC 25
Smac 20 & HIV, Urinalysis, VDRL, Cocaine& Marijuana
$1400
STD1M STD1 Male Profile
Urethral Micro Swab,Chlamydia abs, Chlamydia Antigen urine/swab, Gonorrhoea swab&Treponema Pallidum(Syphillis), CT-NG (Chlamydia Trachomatis/Neisseria Gonorrhoeae- BY PCR
$1650
STD2M STD2 Male Profile Plus
STD1 Male Profile,HBsAg,HCVAb IgG&IgM & HIV1 & 2 Ab 4th Generation,
$2510
STD3F STD3 Female Profile
HVS, Chlamydia abs, Chlamydia Antigen urine/swab, Gonorrhoea swab&Treponema Pallidum(Syphillis)& HIV1& 2 Ab 4th Generation, CT-NG (Chlamydia Trachomatis/Neisseria Gonorrhoeae- BY PCR
$1500
STD4F STD4 Female Profile Plus
STD3 Female Profile, Herpes Profile & HBsAg $2200
STD5 STD5 Blood Only
Treponema Pallidum(Syphillis),HIV1&2Ab 4th Generation,HBsAg&HCVAb IgG&IgM
$620
TESTF
Testicular Function
FSH, LH, Prolactin & Testosterone $550
Page 6
6 | P a g e
CODE PROFILE COMPONENTS COST
THSC Thalassaemia
Screen
A2 Quantitation & Haemoglobin Electrophoresis (SCT) Quantification
$350
Thyroid
Antibodies(A) TG ,ATA , ATG $800
TFTA Thyroid Profile
1 FT4 &TSH $200
TFTB Thyroid Profile
2 T4, TSH, FT3 &FT4 $360
TFTC Thyroid Profile
3 FT3, FT4, TSH $260
TORCH
Torch Profile
Rubella IgG&IgM, Cytomegalo virus IgG&IgM, Herpes I,II IgG&IgM, Toxoplasmosis IgG&IgM
$1400
TTT Triple Test AFP, HCG and Free Estriol 14-22 weeks
$700
MTS
Maternal Health Screen Double
Test
Free Beta HCG,PAPP-A (Preganancy Associated Plasma Protein) 9 Weeks to 13 Weeks and 6 Days (First Trimester Screening)
$800
QUAD Quadruple Test AFP, HCG, Free Estriol, Inhibin (14-21 weeks) second trimester
$1000
U/E Urea
&Electrolytes Electrolytes Panel 1, Bicarbonate, Urea, Creatinine $300
Urine Bence Jones Protein
Elect
Immunotyping Kappa & Lambda Free Light Chain
$2000
VIRA Viral Anitbody
Screen
Influenza A Virus IgG, Measles IgG & IgM,Mumps IgG & IgM,Adenovirus IgG & Igm, Chlamydia ab & Mcoplasma IgG &IgM
$5300
FVWF Von Willebrand
Profile Von Willebrand factor, Factor VIII $2280
Page 7
7 | P a g e
CODE TEST SAMPLE COST
A2 A2 Quantitation A $300
ABSCESS
Abscess M/C/S
J $150
ACR ABS Acetylcholin Receptor Antibodies B $1500
TAP Acid Phosphatase - Total & T.L. B $150
ACTH ACTH (plasma) A (PLASTIC
TUBE) $800
AFP tumor B $250
Aldolase J $540
ALDOS Aldosterone B $300
ALKP Alkaline Phosphatase B $80
APLPHA Alpha 1 Antitrypsin $250
AF Alpha Feto Protein B $250
5 Alpha Dihydro Testosterone NEW B $1365
GPT ALT B $70
AMY Amylase (blood) B $120
ANDP Androstenedione B $1400
ACE Angiotensin Converting Enzyme B $800
SCA Anti Saccharomyces Cerevisiae Iga B $500
ASCAG Anti Saccharomyces Cerevisiae Igg B $500
Anti Adenovirus Igg B $300
Anti Adenoviurs Igm B $300
B2GP Anti B2 Glycoprotein Igg B $300
Anti B2 Glycoprotein Igm B $300
WB-BORRELIA
Anti Borrelia (Whole Anitgen Plus Vise)(Western Blot)
J $1000
BORR IGG,
BORR IGM Anti Borrelia(Lyme Disease)Igg,Igm B $1300
ACCP Anti CCP Antibodies B $250
GAD Anti Gad Igg(Glutamic Acid Decarboxylase )
B $1300
Page 8
8 | P a g e
CODE TEST SAMPLE COST
AGAB Anti Gliadin Abs Iga,Igm B $600
HN1 Anti Influenza A Virus Igg B $300
IFAB Anti Intrinsic Factor B $900
ALEGIONA Anti Legionella Iga B $400
ALEGIONG Anti Legionella Igg B $400
ALEGIONM
Anti Legionella Igm B $400
Antimicrosomal(TPO) B $300
AMH Anti Mulleiran Hormone B $700
MYCO Anti Mycoplasma Igg B $400
MCPM Anti Mycoplasma Igm B $400
ANTIPBIA Anti Parovovirus Igg J $750
ANTIPBIAM
Anti Parovovirus Igm J $750
GASP Anti PCA Parietal Cell Ag Gastric parietal
B $680
HASA Anti Sperm Abs Iga B $250
HASGG Anti Sperm Abs Igg B $250
HASGM Anti Sperm Abs Igm B $250
ATIII Anti Thrombin III C $350
TAA Anti Tissue Transglutaminase Iga B $300
TAAG Anti Tissue Transglutaminase Igg B $300
TREP Anti Treponemal Ab B $200
CARD Anticardiolipin Antibodies Iga, Igg, Igm
B $530
DNA Anti-Dna(Anti-Dsdna Double-Stranded)
B $160
WB-HPY Anti-Helicobacter Pylori- Western Blot
J $350
WB-HSV Anti-HSV I & 2- western blot
J $900
MITO Antimitochondrial Antibody (LKM) Liver Disease
B $600
Page 9
9 | P a g e
CODE TEST SAMPLE COST
ANF Antinuclear Antibodies (ANF) B $180
ASM Anti-Smooth Muscle B $400
ATG Anti-Thyroglobulin Ab B $200
ATA Anti-TPO AB(Thyroid Peroxidase) B $300
APOA Apolipoprotein A B $350
APOB Apolipoprotein B B $350
ASOT ASOT B $120
ASPF Aspirate Fluid For Culture J $160
GOT AST(SGOT) B $80
BCR-ABL BCR-ABL (chronic myelogenpus/acute lymphoblastic leukemia assy-by pcr
A $1500
Bence Jones Protein J $2000
BENZE Benzene RU $1090
BMG Beta 2 Microglobulin Igg/Igm B $700
BHCG Beta HCG B $300
BI Bicarbonate B $80
BILI Bilirubin – Total B $100
Bilirubin (Urine) RU $80
BT Bleeding Time J $60
BCT2 Blood Culture O2 + Ano2 2xBC $300
EACH
PB Blood Lead A $300
GROUP Blood Type & Rh B $50
BLAFB Bronchial Lavage For AFB B $150
BLCS Bronchial Lavage For C & S B $250
MTB-RIFB MTB-RIFB(mycobacterium tuberculosis/ rifampin- resistance – bronchial fluid by pcr
J $950
BNP B-Type Natriuretic Peptide A $750
BSMEAR Buccal Smear For BARR Bodies J $200
Page 10
10 | P a g e
CODE TEST SAMPLE COST
Catecholamines – Dopamine, Epinephrine Norepinephrine
NEW J $300 $300 $300
BUN Bun B $70
CANCA C Anca (anti-neutrophil cytoplasmic abs)
B $450
HSC C Reactive Protein (high sensitivity)-CRP
B $120
CRP CRP (C reactive protein) B $120
C1 C1 Esterase B $795
C3 C3 complement B $200
C4 C4 complement B $200
CA125 Ca 125 (ovaries) B $300
CA153 Ca 15.3 (breasts) B $350
CA199 Ca 19.9 (G.I. Tract) B $350
CA Calcium B $80
UCA Calcium (24 hr urine) CU $130
FBC CBC (includes differential and platelets
A $100
CEA CEA (carcinoembryonic antigen) B $300
CERU Ceruloplasmin B $600
CH50 CH-50 J $300
CHIGG Chagas Disease (t. Cruzi) B $1500
CHIKUN IGG
Chikungunya Igg J $200
CHIKUN IGM
Chikungunya Igm J $200
CHLAMG Chlamydia Abs Igg B $160
CHLAMM Chlamydia Abs Igm B $200
CHLAMA Chlamydia Antigen (urine or swab) RU/Chls $160
CL Chloride B $70
Chloride,Random Urine RU $130
Page 11
11 | P a g e
CODE TEST SAMPLE COST
CHOL Cholesterol B $60
CHES Cholinesterase B $150
CKMB CKMB B $200
SCDT Clostridium Difficile Toxin/Ag RF $500
CT Clotting time J $60
DCT Coombs -Direct Antiglobulin Test B $120
ICT Coombs test - Indirect Antiglobulin Test
B $120
COPP Copper B $490
CORTAM Cortisol (am) B $160
CORTPM Cortisol (pm) B $160
CPEP C-peptide B $500
CPK Creatine Phosphokinase (CPK) B $120
CR Creatinine B $80
CCT Creatinine Clearance B+CU $130
UCREA Creatinine, 24-hour urine CU $130
UCR Creatinine, Random Urine RU $130
CSFR CSF – Routine(Cell Count, Random Sugar, Gram Stain)
CSF $160
CSF CS CSF For Culture & Sensitivity CSF $200
CT-NG (chlamydia trachomatis/neisseria gonorrhoeae-THROAT SWAB by PCR
J $750
CT-NG (chlamydia trachomatis/neisseria gonorrhoeae-RECTAL SWAB by PCR
J $750
CT-NG (chlamydia trachomatis/neisseria gonorrhoeae-VAGINAL SWAB by PCR
J $750
CT-NG CT-NG (chlamydia trachomatis/neisseria gonorrhoeae- by PCR
J $750
CYCL Cyclosporine A $400
CMVIGG Cytomegalovirus Igg Antibodies B $200
Page 12
12 | P a g e
CODE TEST SAMPLE COST
CMVIGM Cytomegalovirus Igm Antibodies B $200
DD D-Dimers (fibrinogen degradation products)
C $180
DENG Dengue Igg /Igm B $160
DHS DHEAS B $350
DGX Digoxin B $250
DHT Dihydrotestosterone $1365
DIL Dilantin (phenytoin) B $250
PILOT TUBE
Direct matching - cross matching of 1 pint of blood (cross matching of 1pint.) For blood screen
B $250
DM Direct matching (screening tests on donors)
B $600
DNA DNA (double stranded) antibodies B $180
E.HISTO IGG
E. Histolytica Igg (amebiasis) B $250
EAR Ear swab for culture CS $200
ECHIN IGG Echinococcus Igg B $250
ELECTA Electrolytes B $140
UPOT, UNA+, UCHL
Electrolytes (urine) RU $180
ENA5
ENA 5-(nrnp/sm, sm, rnp70, rnpa, rnpc, ss-a, ro-52, ss-b, scl70, pm-scl, jo-1, cenpb, pcna, dsdna, nucleosomes, histones, rib. P-prot., ama-m3)
B $750
ENA 23 NEW B $995
EBVIGG Epstein-Barr Virus Igg B $250
EBVIGM Epstein-Barr Virus Igm B $250
ESR ESR (westergren) A $60
E2 Estradiol B $160
Estriol J $200
E1 Estrone J $1485
Page 13
13 | P a g e
CODE TEST SAMPLE COST
Ethylbenzene RU $700
EYE Eye swab for culture CS $200
FIX Factor 1X C $450
FVL Factor V(Leiden) C $780
FV111 Factor V111 C $450
FBCESR FBC & ESR A $140
FCGC Fecal Crypto/Giardia Ag Combo RF $300
FER Ferritin B $250
FIB Fibrinogen C $350
FK5 FK506(TACROLIMUS) NEW A $600
FLUIDC/S Fluid For Culture J $180
RBCF Folate (Rbc)(fasting) A $350
FOL Folate (Serum) Fasting B $250
FREE BETA HCG
Free BETA HCG
B $600
FE3 Free Estriol B $250
KLSRM Free K+L LT Chain QN serum J $1340
KAPPA UR FreeK+L LT Chain QN urine J $2230
FPRS Free Protein S J $1500
FPSA Free PSA B $250
FT3 Free T3 B $90
FT4 Free T4 B $90
FTEST Free Testosterone B $300
FSH FSH B $160
FTI FTI (T3 uptake, Total T4) J $230
FBC Full Blood Count A $100
FUNGAL S&C
Fungal swab culture SWAB $200
G6 G6PD A $200
GGTP Gamma Glutamyl Transpeptidase (GGTP)
B $70
Page 14
14 | P a g e
CODE TEST SAMPLE COST
GASP Gastric Parietal Abs B $680
GTTA Glucose Tolerance Test (2hr) G $150
GTTB Glucose Tolerance Test (3hr) G $160
Glucose Tolerance Test (5hr) G $220
Glucose Tolerance Test With Graph G $160
GLU2H Glucose 2 Hr PP with 50 or 75gms glucose
G $70
FBS Glucose, Fasting G $50
RBS Glucose, Random with Glucose G $60
US/U Glucose, Urine Random RU $50
GAD Glutamic Acid Decarboxylase Igg B $1300
GOND Gonorrhoea(swab) J $160
UGOND Gonorrhoea(urine) RU $160
5HIAA NEW J $300
HPANTI H. Pylori Ag (stool) S $300
HEQ H. Pylori antibodies B $180
HB Haemoglobin A $50
SCTQ
Haemoglobin Electrophoresis (sct) Quantification Hba,As.Ss.Ac.Cc A2
A
$350
Haptoglobin $430
HAVM Hav Igm B $200
HAVG Hav Igg B $200
Hbc Igg B $400
Hbc Igm B $400
HBEAB HbeAB B $300
HBEAB HbeAG B $300
HBSAB HbsAB B $250
HBSAG HbsAG B $100
HCVAB Hcv Ab Igg B $300
A1C HBAIC(Glycosylated HB) B $150
Page 15
15 | P a g e
CODE TEST SAMPLE COST
HCVM Hcv Ab Igm B $300
HDL HDL cholesterol (high density lipids) B $80
HCV Viral Load PCR NEW J 1195
HEPEG Hepatitis E Igg B $720
HEPEM Hepatitis E Igm B $720
HER1G Herpes 1 Antibody lgg B $150
HER1M Herpes 1 Antibody lgm B $150
HER2G Herpes 2 Antibody lgg B $150
HER2M Herpes 2 Antibody lgm BF $150
HIV HIV 1 & 2 Ab 4th generation, p24 Ag B $100
HIV PCR Qualitative NEW J $1195
HIV Viral Load PCR - Quantitative NEW J $995
HCY Homocysteine A/B $500
HPT
Harmony prenatal test(Non-Invasive Prenatal Testing)-common aneuploidy screening from maternal blood
J $5000
HTLV1 HTLV 1 & 11 B $250
HGH Human growth hormone B $650
HVS HVS SWAB $180
HUMAN PAPILLOMA VIRUS(MALE) NEW J $1300
HUMAN PAPILLOMA VIRUS(FEMALE) NEW J $1740
HPV Types 16,18 BY PCR THIN PREP
$995
CSFII Indian Ink CSF $150
IGF-1 IGF-1 (somatomedin) B $350
IGFBP IGF-BP3 B $800
Immunofixation RU $1050
IGA Immunoglobulin A B $160
IGG Immunoglobulin G B $160
IGM Immunoglobulin M B $160
Page 16
16 | P a g e
CODE TEST SAMPLE COST
Ionized calcium NEW J $450
HN1 Influenza A & B Ag B $300
H1N1 PCR NEW J $1195
INS Insulin(fasting) B $200
PTH Intact PTH(fasting) B (plastic tube)
$350
FE Iron B $100
LACT Lactate (lactic acid) A $640
LDH Lactate Dehydrogenase (LDH) B $120
RA Latex fixation (RF) test B $100
PB Lead blood A $350
Legionella B $1200
LEPTO Leptospirosis Abs (Igm) B $300
LASE Lipase B $200
LIP Lipid profile + Blood Sugar B & G $200
LBC Liquid Base Cytology J $170
LI Lithium B $140
LAC Lupus Anticoagulant C $450
LH Luteinising Hormone (LH) B $160
M- xylene RU $230
MG Magnesium (blood) B $130
MALAG Malaria antigen + parasite A $200
MAN Mantoux Test J $200
MEASLG Measles Antibodies (Igg) B $300
MEASLM Measles Antibodies (Igm) B $300
Metanephrines J $300
METD Methadone, urine RU $80
METHYL Methanol RU $400
MXT Methotrexate J $1135
Page 17
17 | P a g e
CODE TEST SAMPLE COST
MALB Microalbumin (urine) RU $120
MONO Monotest B $100
MRSA MRSA SWAB Swab $200
per site
TB-RIF MTB-RIF(mycobacterium tuberculosis / rifampin- resistance- Sputum by pcr
Sputum $950
MTB-RIFB MTB-RIFB(mycobacterium tuberculosis/ rifampin- resistance – bronchial fluid by pcr
J $950
MTB-RIFP MTB-RIFP(mycobacterium tuberculosis/ rifampin- resistance-plueral fluid by pcr
J $950
MUMPSG Mumps Antibodies Igg B $300
MUMPS Mumps Antibodies lgm B $300
MYCO Mycoplasma Igg B $400
MCPM Mycoplasma Igm B $400
MYO Myoglobin (serum) B $150
MYOSIS Myosis J $500
NAILCL Nail scraping for fungus J $160
Normetanephrine NEW RU $300
NICO Nicotine metabolite (blood) B $150
UNICO Nicotine metabolite (urine) RU $150
NS1 Ns1 antigen J $150
OSMO Osmolality(serum) B $350
ROSO Osmolality(urine) RU $350
OXALATE NEW CU
$300
O-xylene RU $230
P-ANCA P - Anca (anti neutrophil cytoplasmic ab)
B $450
PTH Para Thyroid Hormone B(fasting) $350
P-SMEAR Papsmear J $130
Page 18
18 | P a g e
CODE TEST SAMPLE COST
PTT Partial thromboplastin time C $100
PT Prothrombin time with INR C $100
Parvovirus Igg B $850
Parvovirus Igm B $850
PFLUID Peretoneal Fluid Analysis J $100
pH B $150
PHE Phenobarbital B $470
PHOS Phosphorus, inorganic B $80
UPHOS Phosphorus, inorganic 24-hour urine CU $130
PLAT Platelet count A $50
PLEU Pleural Fluid For Culture J $180
K Potassium B $70
Potassium, 24-hour, urine CU $130
UPOT Potassium, random urine RU $100
PREG Pregnancy test, urine RU $50
PPSA PRO PSA B $650
PR Procalcitonin B $400
PROG Progesterone B $160
PROL Prolactin B $160
PSA Prostate Specific Antigen(PSA) B $200
PRC Protein C Activity C $450
PELEC Protein Electrophoresis B $450
PRS Protein S Total C $450
Protein, CSF J $70
TPS Protein, Total B $100
UPRO Protein, urine 24 hour CU $130
UPR Protein, urine random RU $60
FPSA Psa, Free B $250
P-xylene RU $230
QUANT Quantiferon Tb-Gold J $500
Page 19
19 | P a g e
CODE TEST SAMPLE COST
RENI Renin A $300
ARAB Reticulin abs (IGA&IGM) B $1655
RET Reticulocyte count A $80
RA Rheumatoid Factor (latex fixation)
B $120
RIGG Rubella antibody (Igg) B $100
RIGM Rubella antibody (Igm) B $125
SCULT Seminal Fluid For Culture Semen $180
SELOGY Seminology(Routine) Semen $200
GOT SGOT (AST) B $70
SHBG SHBG (Sex Binding Hormone) B $500
SI Sirolimus J $700
FUNGAL Skin Scraping For Fungus/Fungal stain
J
$150
Skin(phemphigus/pemphigoid) Anti Desmoglein 1,3 IgG only
J $295 each
NA+ Sodium B $70
Sodium, 24-hour urine CU $130
UNA+ Sodium, random urine RU $100
SPFUNG Sputum For Fungus SC $300
AFB Sputum For AFB Sputum $100
SPCS Sputum For C/S + Zn Stain SC Sputum
$300
TB Sputum For Tb Culture SC Sputum
$250
SCS Stool For C&S RF $200
SCDT Stool For Clostridium Difficle Toxins RF $500
OBR Stool for Occult Blood Reaction(FIT) RF $100
OPC Stool for Ova Cysts & Parasites RF $100
Streptococcus Pneumoniae Antigen Urine/csf $300
CULT Swab for culture CS $180
SYN FLUID Synovial Fluid For Culture + Gramstain
SC $250
Page 20
20 | P a g e
CODE TEST SAMPLE COST
T3UP T-3 uptake B $90
FT3 T-3, free B $90
T3 T3, total (Triodthyronine) B $90
T4 T-4 total(Thyroxine total) B $90
FT4 T-4, free B $90
FK5 Tacrolimus EDTA $600
TEGR Tegretol (carbamazepine) B $250
TEST Testosterone B $180
FTEST Testosterone free B $300
THEO Theophylline B $350
TG Thyroglobulin B $300
TG1 TG(thyroglobulinantibodies) & TSI B $1200
TCULT Throat swab for culture & sensitivity CS SWAB $180
TT Thrombin time C $150
TBG Thyroid Binding Globulin (TBG) B $670
ATA Thyroid Peroxidase(Anti TPO Ab) B $300
TSH
Thyroid Stimulating Hormone (TSH) B $130
TSI Thyroid Stimulating Immunoglobin (TSI)
B $900
TAA Tissue Transglutamase Iga B $300
TAAG Tissue Transglutamase Igm B $300
Toluene RU $700
TNGC Tongue Culture J $180
TIGE Total IGE B $180
TIBC Total Iron Binding Capacity B $100
TOXO Toxocara antibodies Igg B $300
TXQ Toxoplasma antibodies Igg B $200
TXM Toxoplasma antibodies lGM B $200
TRS% Transferrin Saturation % B $70
Page 21
21 | P a g e
CODE TEST SAMPLE COST
TRPP Treponema Pallidum(Syphillis) by Elisa
B $200
TRIG Triglycerides B $70
TTT Triple test (AF, Beta HCG, Estriol) (14-22 weeks)
B $700
MTS
Maternal health screen Double Test-Free Beta Hcg,Papp-A (Pregnancy Plasma Protein)9Weeks To 13 Weeks And 6 Days (FirstTrimester Screening)
B $800
QUAD TEST
Quadruple test AFP, HCG, Free Estriol,Inhibin (14-22 weeks) second trimester
B $1000
TROPO Troponin 1 ( Quanttitation) B $180
High Sensitive Troponin-I-side NEW J $450
MAN Tuberculine Tine Test (mantoux) J $200
BUN Urea & bun B $70
Urea (urine) RU $70
USWAB Urethal micro swab culture & sensitivity
J $190
UA Uric acid B $80
UUA Uric acid, 24-hour urine CU $130
UURIC ACID
Uric acid (urine) RU $80
Urinary Cortisol $500
UCHL Urinary chloride RU $130
UPOT Urinary potassium RU $130
UNA+ Urinary sodium RU $130
Urine acetone RU $20
Urine bile RU $20
UCS Urine for culture & sensitivity SC $160
MCS Urine for micro culture & sensitivity SC $160
RMCS Urine for routine culture & sensitivity SC
$190
MALB Microalbumin (urine) RU $120
Page 22
22 | P a g e
CODE TEST SAMPLE COST
Urine For Tb Culture RU $250
ULA Urine Legionella Antigen Urine $395
USIS Urine Micro RU $80
UMY Urine Myoglobin Urine $920
UPR Urine Protein (24 Hr) RU $130
US/U Urine Sugar RU $50
Urine Routine/ (Sg, Ph, Protein,& Sugar)
RU $40
URO Urobilinogen, Inc Bilirubin RU
$80
VALP Valporic Acid B $300
VIGG Varicella zoster Igg B $300
VIGM Varicella zoster Igm B $300
VDRL VDRL B $80
B12 Vitamin B12 (Fasting) B $250
VITD Vitamin D B $500
VBF Von Willebrand Factor C $1500
WR Widal Reaction B $250
WOUND Wound Swab For Culture CS $200
Page 23
23 | P a g e
NEW TEST NEW TEST NEW TEST NEW TEST AVAILABLEAVAILABLEAVAILABLEAVAILABLE
5 Alpha Dihydro Testosterone (Dihydrotestosterone) $1365
5HIAA $300
Catecholamines – Dopamine, Epinephrine Norepinephrine
$300 $300 $300
ENA23 $995
FK506(TACROLIMUS $600
H1N1 PCR $1195
Haptoglobin $430
HCV Viral Load PCR $1195
High Sensitive Troponin-I-side $450
HIV PCR Qualitative $1195
HIV Viral Load PCR - Quantitative $995
HPV 16,18 Ag $995
HUMAN PAPILLOMA VIRUS(FEMALE) $1740
HUMAN PAPILLOMA VIRUS(MALE) $1300
Immunofixation $1050
Ionized calcium $450
Normetanephrine $300
pH $150
OXALATE $300
Urine Bence Jones Protein Elect -Immunotyping Kappa & Lambda Free Light Chain
$2000
Page 24
24 | P a g e
ALLERGEN INDIVIDUAL TEST Sample Cost
HOUSE DUST Mites B $300 INSECTS Cockroach B $300
ANIMAL Cat Epithelium B $300
Dog hair & Epithelium B $300
MOULD Penicillia B $300
Aspergilli 1/ Aspergilli 2 B $300 ea
FOOD Hen’s Egg White B $300
Hen’s Egg Yolk B $300
Cow Milk Protein B $300
Wheat Flour B $300
Rice B $300
Soyabean B $300
Peanut B $300
Beef,cooked B $300
Fish B $300
Shrimp B $300
Crab B $300
Prawn B $300
Chocolate B $300 Glutamate B $300 Coconut B $300
MITES Dermatophag .F. B $300
ANIMALS Feathers – Pigeon/ Chicken B $300 ea
LATEX Hevea brasiliensis B $300
Latex(caotchoue) B $300
TIMO Timothy Grass B $300
CORN Corn B $300
SESAME Sesame Seeds B $300
Page 25
25 | P a g e
ALLERGY PANELS
IgE Allergy Profile
(Food)
• Fish
• Cows Milk
• Egg White
• Egg Yolk
• Peanut
• Sesame
• Soya
• Wheat
IgE Allergy Profile
(Inhalants)
• Aspergillus
• Cat Dander
• Derma farinae
• Dog Dander
• House Dust Mite
• Timothy Grass
Cost: $2000 Cost: $1500
IgE Allergy Profile
(Children’s Panel)
• Cat Dander
• Cows Milk
• Egg White; Egg Yolk
• Mite, Pteronyssinus
• Peanut
• Soya Bean
• Timothy Grass
• Wheat Flour
IgE Allergy Profile
(Shellfish)
• Crab
• Lobster
• Prawns
• Shrimp
Cost: $2550 Cost: $1000
Eczema Provoking Profile
• Cat Dander
• Egg White
• Egg Yolk
• Fish Mix
• House Dust Mite
• Milk
• Peanut
• Soya Bean
Rhinitis Provoking Profile
• Cat Dander
• Dog Dander
• Egg White
• Egg Yolk
• House Dust Mite
• Milk
• Peanut
• Timothy Grass
Cost: $2000 Cost: $2000
Page 26
26 | P a g e
Test Sample Reqs Cost
BLOOD CHROMOSOMES
CHROMOSOMAL ANALYSIS (KARYOTYPING ) H $3800
CHROMOSOME ANALYSIS PRODUCTS OF CONCEPTION
PLACENTAL $4100
TISSUE CULTURE
Test Sample Reqs Cost
AMINO PCR AF $3185
AMINOCENTESIS WITH PCR & CULTURE AF $4400
HLA TYPING
Test Sample Reqs Cost
HLA-B27 MOLECULAR ASSAY EDTA $500
HLA A,B,C & DR. MOLECULAR ASSAY EDTA $6100
DNA TESTING FOR PATERNITY/MATERNITY, IMMIGRATION, INHERITANCIDENTITY
SWAB $1800
GENETICS
Test Sample Reqs Cost
DI GEORGE SYNDRONE EDTA(2) $7765
CYSTIC FIBROSIS EDTA(2) $2790
FRAGILE X SYNDROME SCREED EDTA (4) $4250
JAK 2 MUTATION EDTA $4100
SPINAL MUSCULAR ATROPHY EDTA $5000
HIGH RESOLUTION MOLECULAR SCREEN (ARRAY CGH)
EDTA
$6500
Test Sample Reqs Cost
BREAST/OVARIAN CANCER
-BRCA1 & BRCA2 FULL SEQUENCING & DELETIONS (CLINICAL HISTORY & PATIENT CONSENT FORM REQUIRED)
2PURPLE TOP
TUBES
$9000
Page 27
27 | P a g e
SHIPPING TEST AVAILABLE
TEST SAMPLE COST
ACETYLCHOLINE RECEPTOR BLOCKING ANTIBODIES, SERUM SERUM $470
ACID LABILE SUBUNIT (ALS) SERUM $660
ADENOSINE DEAMINASE SERUM $1750
ALDOLASE SERUM $540
ALLERGY CURRY POWDER SERUM $500
ALUMINIUM PLASMA OR SERUM OR
WHOLE BLOOD $700
AMMONIA LEVELS EDTA PLASMA $600
ANTI- DIURETIC HORMONE EDTA PLASMA $2620
APL (PML-RARA) QUANT EDTA WHOLE BLOOD $4965
ASPERGILLUS ANTIGEN SERUM $1750
AVIAN PRECIPITIN SERUM $2870
B- THALASSAEMIA AMNIOTIC FLUID $22250
BILE ACIDS SERUM $620
CA 27.29 SERUM $300
CALPROTECTIN FECAL (STOOL) $1690
CATECHOLAMINES PLASMA EDTA $350
CD4/CD8 RATIO PLEASE CONTACT LAB $1840
CMV DNA PCR PLASMA EDTA $3545
COLLAGEN TYPE I, II, IV ANTIBODIES SERUM $1200
COMPLEMENT C1Q QUANTITATIVE SERUM $719
COMPLEMENT C2 SERUM $805
COXSACKIE VIRUS GROUP B ANTI-BODIES SERUM $1500
CRYOGLOBULIN SERUM $1590
CRYSTALS, SYNOVIAL / JOINT FLUID SYNOVIAL FLUID ONLY $610
DEXAMETHASONE SERUM $690
ERYTHROPOIETIN SERUM $300
ESTRONE SERUM SERUM $1485
FACTOR II DNA CITRATED PLASMA $2730
FACTOR VII CITRATED PLASMA $1590
Page 28
28 | P a g e
TEST SAMPLE COST
FECAL ELASTASE FECAL (STOOL) $1900
FILARIA ANTIBODIES SERUM $1525
FRUCTOSAMINE SERUM $300
GENTAMICIN, SERUM, PEAK/TROUGH SERUM $1004 HARMONY PRE-NATAL TEST SERUM $4300
HBV DNA PCR SERUM $4740
HCV DNA PCR SERUM $3800
HISTOPLASMA ABS, QN, DID SERUM $1120
HISTOPLASMA ANTIGEN SERUM $970
HIV DNA PCR EDTA PLASMA $3530
HLA B27 DISEASE ASSOCIATION WHOLE BLOOD EDTA $500
HOMOVANILLIC ACID RANDOM URINE $1010
HUNTINGTON DISEASE (2 )WHOLE BLOOD EDTA $4000
IgG, SUBCLASS 4 (IV) SERUM $4240
IMMUNOGLOBULINS, CSF CSF $1390
INSULIN AUTOANTIBODIES SERUM $875
INSULIN FREE AND TOTAL SERUM $760
IODINE SERUM $560
ISLET CELL ANTI-BODIES SERUM $1040
ISOHEMAGGLUTININ TITER WHOLE BLOOD $1140
JAK2 MUTATION EDTA WHOLE BLOOD $4100
LIPOPROTEIN A SERUM $560
LYME (B. burdorferi) PCR WHOLE BLOOD EDTA $4430
MAGNESIUM RBC WHOLE BLOOD EDTA $840
MERCURY BLOOD ROYAL BLUE $800
METANEPHRINES RANDOM URINE $1010
METANEPHRINES PLASMA EDTA $2600
METHYLMALONIC ACID SERUM $460
MUSCULAR DYSTROPHY WHOLE BLOOD EDTA $7700
NEISSERIA GONORRHEA ABS, TOTAL SERUM $790
OLIGOCLONAL BANDING SERUM AND CSF $500 PCA3 (Molecular test for the detection of prostate cancer from urine) PLEASE CONTACT $4300
Page 29
29 | P a g e
TEST SAMPLE COST
PORPHRINS FRACTIONATED
PLASMA $1635
PORPHYRINS 24 HR URINE $1370
PORPHYRINS RANDOM URINE $510
PROINSULIN SERUM $1935
PROINSULIN SERUM $1935
PROTEIN C ANTIGEN CITRATED PLASMA $1400
PROTEIN S ANTIGEN CITRATED PLASMA $3500
PROTEIN S FREE CITRATED PLASMA $3500
REVERSE T3 SERUM $1500
SEROTININ SERUM $2010
STONE ANALYSIS PLEASE CONTACT LAB $750
STOOL LACTOFERRIN FECAL (STOOL) $1200
STRIATIONAL ANTIBODIES SERUM $300
STRONGLOIDIASIS, IgG SERUM $800
SULFONYLUREA SCREEN, QT SERUM/PLASMA $1420
THIOPURINE METHYLTRANSFERASE WHOLE BLOOD $2730
TRANSFERRIN SERUM $370
VANILLYMANDELIC ACID (VMA) 24 HR URINE $450
VISCOSITY, SERUM SERUM $300 VITAMIN B12 UNSATURATED BINDING CAPACITY SERUM $860 VOLTAGE GATED POTASSIUM CHANNEL ANTIBODIES SERUM $2560
ZINC SERUM $675
Page 30
30 | P a g e
OCCUPATIONAL HEALTH SERVICES
DESCRIPTION COST
Medical Examination Annual & Periodic Surveillance Exams Executive Physical Examinations Fitness-for-Duty Examinations Hazardous Material Examinations (Haz-Mat) Independent Medical Evaluations and second opinions
$150-$400
Audiometry $100
Chester Step Test $200
Electrocardiogram with report $200
Ishihara Test for Color Blindness $80
Respiratory Fit Test $200
Spirometry $230
UKOOA Medical $750
Vision Screening $80
SUBSTANCE ABUSE
Alcohol ( breath) $80
Alcohol screen (blood) $80
Alcohol screen (urine) $80
Amphetamines (urine) $80
Barbiturates(urine) $80
Benzodiazepine(urine) $80
Cannabinoids (marijuana) by GC/MS $600
Cannabinoids (marijuana)screen (urine) $80
Cocaine ( Benzoylecgonine) by GC/MS $600
Cocaine ( Benzoylecgonine) screen(urine) $80
Estacy(urine) $80
Methadone(urine) $120
Opiates Screen (Urine) $80
Phencyclidine (PCP) $80
Page 31
31 | P a g e
CARDIOVASCULAR SERVICES
DESCRIPTION COST
Electrocardiogram $200
Echocardiogram $800
Stress Electrocardiogram $800
Stress Echocardiogram $2200
Holter Monitoring $800
Page 32
32 | P a g e
VICTORIA DIAGNOSTIC IMAGING CENTRE LTD
PRICE LIST (X-RAYS, MAMMOGRAMS, ULTRASOUNDS& DOPPLER)
EXAMINATIONS X-RAY
FEES
CHEST PA $140
CHEST – PA & Lat $240
RIBS – PA & OBLIQ $240
ABDOMEN – AP $180
ABDOMEN – E & S $245
PELVIC – AP $160
PELVIC WITH ONE HIP $200
HIP – AP & OBLIQ $200
HIP – BOTH $245
COCCYX $200
S.I.J – AP & 2 OBLIQ $245
SKULL – AP & LAT $225
SKULL – 3 VIEWS $325
SINUSES – OM & LAT $240
SINUSES – 3 VIEWS $315
MASTOIDS – TOWNES 2 AXIOLATERALS $300
LONG BONES $640
SCOLIOSIS $200
C- SPINE – AP & LAT $200
T – SPINE AP & LAT $200
L/S SPINE AP & LAT $200 WITH OBL $300
HUMERUS – AP & LAT $200
SHOULDER – 2 VIEWS $200
CHEST, T & L/S SPINE $540
CLAVICLE $140
ELBOW $140
FOREARM $175
HAND / WRIST $145
FEMUR $200
Page 33
33 | P a g e
KNEE $200
TIB/FIB $175
ANKLE $145
FOOT $145
HEEL(S) (1/2) $145
SPECIALS
BARIUM MEAL & SWALLOW $480
BARIUM MEAL & FT $500
BARIUM ENEMA $515
I.V.P $715
HSG $440 + $300 if cannula is used.
CYSTOGRAM $715
MCUG $800
GASTROGRAFIN $1200
FLUROSCOPY $1000
ASCENDING URETHROGRAM $1500
FISTULOGRAM $715
MAMMOGRAM
ONE BREAST $150
BOTH BREAST $300
MAMMOGRAM AND BREAST U/S $675 (Only Dr. P Morris Patients)
ULTRASOUND
ABDOMEN $400
PELVIC / PELVIC TV $350 / $400
ABDOMEN AND PELVIC $600
OBSTETRIC $350
PROSTATE (TA) $450
PROSTATE (TR) $550
THYROID / SMALL PART $470
TESTIS / SCROTUM $450
RENAL & KIDNEYS $450
BREAST $450
RENAL & P ROSTATE $700
SIS – (Saline Infusion Sonogram) $1500
FNAC $2500
PROSTATE BIOPSY $4000
Page 34
34 | P a g e
DOPPLER
UPPER LIMB $670
UPPER LIMB (BOTH) $1270
LOWER LIMB ( ONE) $670
LOWER LIMB (BOTH) $1270
CAROTID $870
BREAST $470
THYROID $470
RENAL $670
TESTIS $670
VENOUS $670
ARTERIAL $670
MUSCULAR $670
SKELETAL $670
Radiologist Fees Included.
Page 35
35 | P a g e
VICTORIA CT SCAN PRICE LIST
EXAMINATIONS
CT
FEES
Brain N/C + C $1200 / 1500
Cerebral Angiogram $2000
Pituitary Fossa + C $1700
Brain / Orbits N/C + C $1800 / 2000
Brain / Orbits / Sinuses N/C + C $1800 / 2000
Neck N/C + C $2200 / 2500
C- Spine / Neck / T- Spine $2000
Chest N/C + C $1800 / 2000
Pulmonary Angiogram $2500
Temporal Bones / Mastoids N/C $1500 / 2000
T.M. Joints N/C $2000
Facial Bones N/C $2200
Sinuses N/C $1500
Chest HRCT N/C $2700
Abdomen N/C + C $1800 / 2200
Abdomen and Pelvis / KUB N/C + C $2000 / 2500
Abdomen and Pelvis + C $3000
Pelvis N/C + C $1500 / 2000
Abdomen and Pelvis KUB N/C + C $2500
Knee N/C + C $1500
Foot / Ankle $1500 / 2000
EXAMINATIONS
CT
FEES
Hand / Wrist/ Elbow $1500
Pancreatic Protocol $3000
Head / Chest / Abdomen / Pelvis $4000
Page 36
36 | P a g e
Renal Protocol $2600
CT IVP + C $2600
Chest / Abdomen / Pelvis $3500
Colonoscopy $2500
Virtual Colonoscopy N/C $3000
C/ T / L/S Spine N/C $2000
Calcium Score $1800
Coronary Angiogram $6000
3 Phase Liver + C $2600
Aortic Root $2500
CT Angiography CTA
CTA Brain / Head + C $2600
CTA Coronary Arteries (Heart) $4100
CTA Renal Arteries $2700
Aortogram Thoracic / Abdomen) $4100
CTA Neck (Carotid) + C $2600
CTA Pulmonary Arteries + C $2900
CTA Femoral Lower Limbs $3600
CTA Upper limbs $3600
Page 37
37 | P a g e
Sample requirements
Vacutainer Anticoagulant Capacity Sample types
Lavender EDTA 2.5ml
Red None 4ml
Light Blue Citrate 4ml
Grey Fluoride oxalate 2.5ml
Green Lithium heparin 4ml
Dark Blue Sodium heparin 4ml
Streck Cyto-chex BCT Vacutainers for lymphocyte subsets (stable for up to 7 days) Chex
Blood culture bottle: contact laboratory BC
Contact laboratory for advice on sample taking J
Test by appointment X
Random faeces RF
3-day faecal collection LF
Random urine RU
30ml aliquot from a 24-hour urine collection – state total volume CU
30ml aliquot from a 24-hour urine collection with 10ml of 0.1N hydrochloric acid added – state total volume PU
Early morning urine (1st sample of the day) EMU
Sterile 60ml container SC
Cytyc Thin Prep Vial TPV
Orange/Blue swab for culture – swab in transport medium STM
Black charcoal swab CS
Green viral swab VS
PCR swab for Chlamydia/N.Gonorrhoea Chls
Tap/bottled water mouth wash – 20mls MW
Amniotic fluid (5mls PCR – 10mls Karyotype) AF
Page 38
38 | P a g e
Chorionic villus (medium provided by laboratory) CVS
