S.No

Test Name

Amount

1

3 D Charge

200

2

ABG Cardiothorosic

550

3

Absolute eosinophil count & VEC

0

4

AC

600

5

Alkaline Phosphatase

0

6

Angiography

1000

7

Angiography HZL

500

8

Ascitic fluid protein

10

9

ASLO test

0

10

Audiometry / ENT / PTA

50

11

Audiometry / Impedance

20

12

AUTOMATED VISUAL ANALYZER

500

13

B.M.V

29000

14

Ba enema study

300

15

Ba fallow through (ileoceacleregion)

150

16

BA Meal & follow through (small bowel study)

350

17

Ba meal study (Stomach & duodenum)

250

18

Ba Swallow (Oesophagousgram)

150

19

Biopasies (small one block)

50

20

Biopsy examination Big

100

21

Biopsy examination Small

50

22

BL Albumin

0

23

BL VDRL test

75

24

BL Acid Phosphatase

20

25

BL AFB CULTURE

15

26

BL AFP

250

27

BL Amylase

0

28

BL BHCG

150

29

BL Bilirubin Total,Direct, Indirect

0

30

BL BLOOD CULTURE

35

31

BL C.S.F. Sugar protein chloride

0

32

BL CA 125

100

33

BL Calcium

0

34

BL CBC

0

35

BL CEA

100

36

BL Choloesterol

0

37

BL CORTISOL

300

38

BL Creatinine

0

39

BL DRAIN CULTURE

20

40

BL ESTROGEN

100

41

BL FERRITIN

150

42

BL FLUID CULTURE

20

43

BL Fluid Cytology

50

44

BL FOLATE

350

45

Bl for MP

0

46

BL FREE T3

75

47

BL FREE T4

75

48

BL FSH

75

49

BL TSH

75

50

BL FUNGAL CULTURE

15

51

BL Globulin

0

52

BL GTT

60

53

BL Hb, TLC, DLC, ESR

0

54

BL HBsAg test

0

55

BL HS TROP T STAT

450

56

BL LH

100

57

BL Lipid profile

0

58

BL PROGESTERONE

250

59

BL PROLACTIN

75

60

BL PSA

200

61

BL PTH STAT

450

62

BL PUS CULTURE

20

63

BL RBC FOR SIKLING TEST

40

64

BL SGOT

0

65

BL SGPT

0

66

BL SPUTUM CULTURE

20

67

BL SUGAR (R)

10

68

BL SWAB CULTURE

20

69

BL T3

75

70

BL T3 T4 TSH

225

71

BL T4

75

72

BL TEC / VEC

10

73

BL TESTOSTERONE

150

74

BL Total protein

0

75

BL TSH

75

76

BL Urea

0

77

BL Uric Acid

0

78

BL Urine Complete

0

79

BL URINE CULTURE

20

80

BL VIT B 12

120

81

BL Widal test

0

82

Blood Glucose

0

83

Blood group

0

84

Blood Sugar (F)

0

85

Blood Sugar (PP)

0

86

Blood Test for Trans.FFP (GP, MP, HIV, VDRL, H)

400

87

Blood Test for Trans.Indoor (GP, MP, HIV, VDRL, H)

0

88

Blood Test for Trans.Outdoor (GP,MP,HIV,VDRL,H)

850

89

BMV Procedure

1000

90

Bone marrow exam

50

91

Braketherapy for one fraction

1000

92

Braketherapy more than five fraction

2000

93

Braketherapy more than one & below five fraction

1500

94

Bronchogram (constrast extra)

350

95

BT & CT

0

96

CD 4 cell count

0

97

CD Writing Charge

200

98

Colonoscopy

200

99

Continuous Investigation

0

100

Coomb’s test

60

101

CRP test

0

102

CSF

0

103

CSF examination

50

104

CT Angio

3000

105

CT Scan (brain / PNS/Ear CECT) (Constrast extra)

900

106

CT scan (brain NCCT)

900

107

CT Scan spine/ chest/abd/ pelvis, Extremeties (Upper & Lower) (Const

1400

108

CTNL (CARDIOLOGY)

900

109

CUG Cysteogram (constrast extra)

250

110

Cystoscopy

200

111

Cystourethrogram (constrast extra)

250

112

Delux

300

113

Dengue

0

114

Dengue test

300

115

Digital Abdomen (FPA) Standing

0

116

Digital Abdomen (KUB) AP

0

117

Digital Ankle AP & Lateral

0

118

DIGITAL ANKLE AP/LAT/AXIAL/OBLIQUE

0

119

Digital Ankle axile

0

120

Digital Cervical Spine AP

0

121

Digital Cervical Spine AP & Lateral

0

122

Digital Cervical Spine Lateral

0

123

Digital Chest AP

0

124

Digital Chest Apico lordatic AP

0

125

Digital Chest Dicubitus Lateral

0

126

Digital Chest Lateral

0

127

DIGITAL CHEST OBLIQUE AP/LAT/AXIAL/OBLIQUE

0

128

Digital Chest PA

0

129

Digital Dorsal Spine AP

0

130

Digital Dorsal Spine AP & Lateral

0

131

Digital Dorsal Spine Lateral

0

132

Digital Elbow AP Let

0

133

Digital Foot AP & Lateral

100

134

DIGITAL FORE ARM AP/LT

100

135

Digital Hand AP & Lateral

0

136

Digital Hand AP & Lateral Oblique

0

137

Digital Heel Lateral / AXIEL

0

138

Digital Hip Joint AP

0

139

Digital Hip Joint AP & Lateral

0

140

Digital Hip Joint Frog Position AP

0

141

Digital Hip Joint Lateral

0

142

Digital IVP-I

100

143

Digital IVP-I & II

400

144

Digital IVP-II

300

145

Digital Knee Joint AP & lateral

0

146

Digital Knee Joint AP & lateral & oblique

0

147

Digital Knee Joint AP & Tunnel

0

148

Digital Knee Joint AP Lateral Tunnel / Axil

0

149

Digital Leg Bone with ankle / knee

0

150

Digital Lumbo Sacral Spine AP

0

151

Digital Lumbo Sacral Spine AP & Lateral

0

152

Digital Lumbo Sacral Spine Lateral

0

153

Digital Mandible AP

0

154

Digital Mandible AP & Lateral

0

155

Digital Mandible Lateral

0

156

Digital Mastoid Lateral

0

157

Digital Nose Both Lateral

0

158

Digital Orbit AP

0

159

Digital Orbit Lateral Oblique

0

160

Digital Pelvis AP

0

161

DIGITAL PELVIS S.I. JOINT

100

162

Digital PNS

0

163

Digital Shoulder AP Let

0

164

DIGITAL SHOULDER AP/AXIAL

0

165

Digital Skull AP

0

166

Digital Skull AP & Lateral

0

167

Digital Skull Lateral

0

168

Digital Soft Tissue Neck Lat

0

169

DIGITAL STYLOID PROCESS

100

170

Digital Thigh with hip or knee

0

171

Digital TM Joint AP

0

172

Digital TM Joint Both Side Lateral

0

173

Digital Wrist AP Lateral

0

174

Digital Wrist AP Lateral Oblique Ulna Deviation

0

175

Digital X-ray (one body part two view spine/ hip/skull)

0

176

Digital X-ray one body part

0

177

DIGITAL X-RAY ONE BODY PART - 3/4 VIEW EXTRI.

0

178

Digital X-ray one body part two view extrimites

0

179

Double Yang Laser Eye

500

180

ECG

0

181

ECHO

700

182

EEG

150

183

EG7 (BAL CHIKITSALAY)

0

184

Electrolyte

0

185

ENMG

800

186

EP Study and RF ablation

2000

187

ESR

0

188

Eye Scan

60

189

Fiber optical lairingoscopy

50

190

Fleural fluid protein

10

191

FNAC test

50

192

FREQ. DOUBLE YOG LASER

500

193

Fungus

25

194

G6 PD test

40

195

General

200

196

Gram’s

0

197

Hair Analysis System

200

198

HCV test

150

199

Hemoglobin estimation

0

200

Histo pathology biopasies

100

201

HIV test

0

202

Holter

500

203

HSG (constrast extra)

200

204

HZL ANGIO PLASTY

500

205

HZL ANGIOGRAPHY

500

206

HZL ECHO

0

207

HZL HOLTER

0

208

HZL PERMANENT PACEMAKER

500

209

HZL TMT

0

210

Inorganic Phosphorus

0

211

IVP (constrast extra)

400

212

KLB

10

213

KOH

10

214

LE Cell phenomenon

50

215

MED. SPIROMETRY

200

216

Memography (Double Breast)

400

217

Memography (Single Breast)

200

218

Microdermabrader System

150

219

MICU Ward

1000

220

Monochromatic excimer Light (MEL) System

200

221

MP QBC

70

222

MPQBC

60

223

Mycobacterim culture (AFB)

20

224

Myeloram (Contrast extra)

250

225

NCV/NEE (ENMG)

800

226

Nephrosotogram

250

227

Nestroff test

40

228

OCG (constrast extra)

150

229

Optimal rapid MP test

200

230

Osmotic fragiligy test

40

231

Paliative cobalt therapy

250

232

PAP’S Smear examination

50

233

PBF Examination

0

234

PCECG & SAECG

200

235

PERFUSIONIST CHARGE

2000

236

Permanent Pacemaker

1000

237

PHACO EMULSIFICATION

100

238

Platelate apheresis Indoor

7000

239

Platelate apheresis Outdoor

7500

240

Platelet count

25

241

Prothrombin time

0

242

PT,PTT,TT

200

243

PTCA

2000

244

PTCA HZL

1000

245

Pus

25

246

RA test

0

247

Redical cobalt therapy

700

248

Reticulocyte count

25

249

Retrograde Pxleogram

250

250

RFC

100

251

Semen examination

20

252

Serum HDL

0

253

Serum Triglycerides

0

254

Sickling test

40

255

SKIN CO2 Laser

200

256

SKIN IPL

300

257

SKIN Nd YAG Laser

300

258

SKIN Q Switched Laser

300

259

Skin VD test

100

260

SONO Colour Doppler

300

261

Sonogram /sialogram/ loporam (constrast extra)

200

262

Sonography (one body system) without film

0

263

Sonography (two body system) without film

0

264

Sonography (two body system+ one extra system) without film

0

265

Sputum

25

266

Sputum for AFB

0

267

Stool

25

268

Stool examination

0

269

SWD (4 Day)

40

270

SWD (5 day)

50

271

SWD (One day)

10

272

SWD (Three day)

30

273

SWD (two day)

20

274

Swine Flu

1000

275

Swine Flu INDOOR

0

276

T tube cholangiogram (constrast extra)

250

277

T3T4TSH

200

278

TB I gG & I gM

300

279

Throat Swab

20

280

TLC, DLC

0

281

TMT

450

282

Tooth Biopsy

150

283

Tooth Composite Filling

150

284

Tooth Episectomy Operation

350

285

Tooth Extraction

20

286

Tooth Flap Surgery (Per Quadrant)

350

287

Tooth Fracture Jaw Wiring

350

288

Tooth Gingivectomy

300

289

Tooth Glass Ionomer Cement

150

290

Tooth Glass Ionomer Cement Filling

150

291

Tooth Impacted Extraction

150

292

Tooth Inter Maxillary

350

293

Tooth Major Surgery

500

294

Tooth Minor Surgery

200

295

Tooth Pedodontics Temp Filling II

50

296

Tooth Pedodontics Temp. Filling I

50

297

Tooth Root Canal Treatment (Anterior)

250

298

Tooth Root Canal Treatment (Posterior)

350

299

Tooth Scaling

75

300

Tooth Silver Filling Class I

30

301

Tooth Silver Filling Class II

50

302

Tooth Temprory Filling

25

303

TOPCON RETINAL

200

304

Torch test

600

305

Upper GI endoscopy

200

306

Upper GI endoscopy & variceal banding/ injection

500

307

UPPER GI Video Endoscopy

500

308

Urine

0

309

Urine examination

25

310

Urine Micro Albumin

150

311

Uronimeter test

30

312

UV Therapy

100

313

Various Fluid

0

314

Various swab culture

20

315

VDRL SER. DILUTION

75

316

VDRL test

0

317

VEP Study ENMG

400

318

VIDEO EEG

400

319

X Abdomen (FPA) Standing

0

320

X Abdomen (KUB) AP

0

321

X Ankle AP & Lateral

0

322

X ANKLE AXIAL / OBLIQUE

0

323

X Ankle Axil

0

324

X Arm AP Lat

0

325

X Cervical Spine AP

0

326

X Cervical Spine Lateral

0

327

X Chest AP

0

328

X Chest Apico lordatic AP

0

329

X Chest Dicubitus Lateral

0

330

X Chest Lateral

0

331

X CHEST OBLIQUE VIEW

0

332

X Chest PA

0

333

X Dental One film

0

334

X Dorsal Spine AP

0

335

X Dorsal Spine Lateral

0

336

X Elbow AP Lat.

0

337

X Foot AP & Lateral

0

338

X ForArm AP Lat

0

339

X Hand AP & Lateral

0

340

X Hand AP & Lateral Oblique

0

341

X Heel Lat / Axiel

0

342

X Hip Joint AP

0

343

X Hip Joint Frog Position AP

0

344

X Hip Joint Lateral

0

345

X KNEE AXIAL / OBLIQUE

0

346

X Knee Joint AP & lateral

0

347

X Knee Joint AP & Tunnel

0

348

X KUB

0

349

X Leg Bone with ankle / knee

0

350

X Lumbo Sacral Spine AP

0

351

X Lumbo Sacral Spine Lateral

0

352

X Mandible AP

0

353

X Mandible Lateral

0

354

X Mastoid Lateral

0

355

X MLC X-RAY ELBOW-WRIST

0

356

X MLC X-RAY PELVIS AP

0

357

X Nose AP

0

358

X Nose Both Lateral

0

359

X Occulusal

0

360

X OPG

0

361

X Orbit AP

0

362

X Orbit Lateral Oblique

0

363

X Pelvis AP

0

364

X PNS

0

365

X Repeat

0

366

X Shoulder AP Lat.

0

367

X Skull AP

0

368

X Skull Lateral

0

369

X Soft Tissue Neck Lat

0

370

X Thigh with hip or knee

0

371

X TM Joint AP

0

372

X TM Joint Both Side Lateral

0

373

X Wrist AP Lateral

0

374

Yang Laser Eye

350

375

Z.N.

15