AS OF FEBRUARY 5, 2024
| ROOMS | CLEAN | INFECTIOUS AREA |
| WARD | 2,360.00 | N/A |
| SEMI-PRIVATE | 2,720.00 | N/A |
| PRIVATE ROOM | 3,060.00 | 3,560.00 |
| LARGE PRIVATE | 3,800.00 | 4,300.00 |
| DELUXE ROOM | 4,400.00 | 4,900.00 |
| SUITE ROOM | 7,400.00 | N/A |
| ISOLATION ROOM | 4,200.00 | 4,700.00 |
| ICU | 5,100.00 | N/A |
| PICU | 4,000.00 | N/A |
| NICU | 2,460.00 | N/A |
AS OF FEBRUARY 5, 2024
| LABORATORY | ||
| BUN | 254.10 | |
| CREATININE | 228.90 | |
| FBS | 216.30 | |
| HBA1C | 1,564.50 | |
| LIPID PROFILE | 827.40 | |
| SGOT | 430.50 | |
| SGPT | 430.50 | |
| URIC ACID | 455.70 | |
| CBC | 354.90 | |
| CBC/ APC | 556.50 | |
| PLATELET COUNT | 581.70 | |
| FECALYSIS | 182.03 | |
| URINALYSIS | 191.10 | |
| CARDIOLOGY | ||
| ECG | 682.50 | |
| 2D ECHO | 4,462.50 | |
| STRESS TEST/TREADMILL EXERCISE | 4,475.10 | |
| PULMONARY | ||
| ARTERIAL BLOOD GAS (ABG) | 2,076.90 | |
| RADIOLOGY | ||
| X-RAY CHEST | 581.95 | |
| X-RAY ABDOMEN UPRIGHT | 838.74 | |
| X-RAY SKULL APL BOTH | 1,866.90 | |
| CT SCAN - NECK PLAIN | 6,834.92 | |
| CT SCAN - WHOLE ABDOMEN PLAIN | 12,400.50 | |
| CT - SCAN CT PLAIN | 7,338.35 | |
| ULTRASOUND - UPPER ABDOMEN & CHEST | 2,100.00 | |
| ULTRASOUND - WHOLE ABDOMEN | 2,941.68 | |
| ULTRASOUND - TRANSVAGINAL | 1,312.50 | |
| ULTRASOUND - KIDNEY, URETER, BLADDER | 1,593.41 | |
AS OF FEBRUARY 5, 2024
| ENDOSCOPY PROCEDURE | ||
| UGIE | 5,100.00 | |
| COLONOSCOPY | 6,500.00 | |
| FLEXIBLE SIGMOIDOSCOPY | 4,500.00 | |
| BRONCHOSCOPY | 5,800.00 | |
| EMERGENCY ROOM PROCEDURE | ||
| MINOR SURGERY | 1,000 to 3,000 | |
| WOUND CARE DRESSING | 370.00 | |
| HEMODIALYSIS PROCEDURE | ||
| HEMODIALYSIS | 8,100.00 | |
| DIALYSIS EXTENDED TREATMENT PER HOUR | 600.00 | |
| OPCC PROCEDURE | ||
| COLOSTOMY CARE | 2,500.00 | |
| REMOVAL OF DRAIN | 2,100.00 | |
| WOUND CARE DRESSING | 200 to 350 | |
| IV INFUSION | 525.00 | |
| OPERATING ROOM PROCEDURE | ||
| EXPLORATION | 5,520.00 | |
| HERNIORRHAPHY | 3,500.00 | |
| APPENDECTOMY | 3,500.00 | |
| LAPARASCOPIC | 5,520.00 | |
| MEDICAL SUPPLIES | ||
| GLOVES EXAMINATION (MICRO, LARGE) | 20.00 | |
| WADDING SHEET | 113.00 | |
| C SECTION DRAPE SET | 5,884.00 | |
| BLOOD TRANSFUSION SET | 551.00 | |
| ORAL AIRWAY | 37.82 | |
| URINE LEG BAG | 150.00 | |
| IV CANNULA G16 WITH WINGS_INJECTION PORT | 105.00 | |
| DIALYSATE PORT CAP VINYL RED | 73.56 | |
| ELASTIC BANDAGE | 31.50 | |
| HYDROGEN PEROXIDE | 33.00 | |
| EFEEDING STOMACH TUBE | 23.53 | |
| THERMAL PAPER FOR EDAN F9 FETAL MONITOR | 1,155.00 | |
| ANESTHESIA BREATHING CIRCUIT | 1,576.00 | |
| ECG ELECTRODES ADULT | 21.00 | |
| FEEDING /STOMACH TUBE | 22.43 | |
| PEDIA CUFF | 588.44 | |
| KELLY FORCEP (CURVED) | 172.33 | |
| MAYO SCISSOR STRAIGHT | 157.62 | |
| PROLENE MESH | 2,472.00 | |
| SUCTION CATHETER | 42.00 | |
| SURGICAL GOWN | 275.00 | |
| ADULT DIAPER | 86.00 | |
| N95 FACEMASK | 215.00 | |
| HEAT & MOISTURE EXCHANGER | 273.20 | |
| ENDOTRACHEAL TUBE | 167.00 | |
| INFUSION SET WITH MICRO DROPS | 52.76 | |
| NASAL OXYGEN CANNULA PEDIA | 98.00 | |
| METZ SCISSOR CURVE | 367.00 | |
| NEEDLE CUTTER | 525.00 | |
| NEEDLE HOLDER | 190.00 | |
| PORTABLE OXIMETER | 3,152.00 | |
| RETRACTOR | 515.00 | |
| SIDE RACK | 1,156.00 | |
| ELECTRODE GEL | 758.00 | |
| FOLEY CATHETER | 58.32 | |
| DUODENAL TUBE | 42.00 | |
| STAINING RACK | 1,155.00 | |
| GAUZE SWAB STERILE | 33.00 | |
For OUTPATIENTS Benefits
| ILLNESS | COVERAGE |
| Case Rate for Hemodialysis | 2,600.00 per session |
| Cast Rate for Outpatient Blood Transfusion | 4,732.00 (one or more units) |
| Thyroidectomy (Total or Complete Cash Benefits) | 40,300.00 |
| Ovarian Cystectomy (Unilateral or Bilateral) | 30,290.00 |
| Pneumonia |
|
| Tonsillectomy (Primary or Secondary) | 23,400.00 |
| Normal Spontaneous Delivery (NSD) |
|
| Tubal Ligation | 5,200.00 |
For INPATIENTS Benefits
| ILLNESS | COVERAGE |
| Intrauterine Device Insertion or IUD | 2,600.00 |
| Vasectomy (Unilateral or Bilateral) | 5,200.00 |
| Viral Hepatitis | 15,340.00 |
| Rheumatic Fever | 13,130.00 |
| Breech Extraction | 15,756.00 |
| Appendectomy/td> | 31,200.00 |
| Cerebral Infarction | 28,000.00 |
| Cerebral Palsy | 12,480.00 |
| Cellulitis | 12,480.00 |
| Cataract Surgery | 16,000.00 |
| Cholecysectomy | 40,300.00 |
| Cholecystitis | 14,690.00 |
| Ceasarian Section | 24,700.00 |
| Congenital Anemia | 19,760.00 |
| Newborn Care Package | 3,835.00 |
| Emphysema | 14,820.00 |
| Upper Respiratory Track Infection (URTI) |
|
| Dengue |
|
| Chronic Onstructive Pulmonary Disease (COPD) | 15,860.00 |
| Congenital Syphilis | 16,640.00 |
| Diabetes Mellitus | **With complications other than Coma and Ketosis: 16,380.00 |
| Asthma |
|
| Congenital Hypothyroidism | 12,870.00 |
Important Note: PRICES ARE SUBJECT TO CHANGE WITHOUT PRIOR NOTICE