St Paul Hospital Cavite Inc.
Evangelizing through SPHC Healthcare Services
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Ultrasound Form
* Date of Birth
* Gender
Female
Male
* Civil Status
Single
Married
Legally Separated
Widowed
* Do you have a prescription from your Physician?
Yes
No
Price List of Ultrasound Procedure (estimated)
Whole Abdomen - P 4,345.00
Upper Abdomen - P2,415.00
Lower Abdomen - P2,415.00
HBT - P1,770.00
HBT - Pancreas / Spleen - P2.050.00
Liver - P 745.00
Gallbladder - P805.00
UB - Pelvic - P 1,610.00
UB - Prostate - P 1,610..00
KUB - P 1,865.00
KUB - Prostate - P 2,415.00
Prostate Gland - P 745.00
Kidneys - P 1,185.00
UB + (pre & post void) - P 805.00
Pelvic (non-pregnant) P 1,025.00
Cranial UTZ - P 2,795.00
Thyroid - P 2,235.00
Anterior Neck - P 3,030.00
Breasts - P 2,640.00
Mass (Soft Tissue) - P2,235.00
Chest UTZ - P 2,840.00
Chest with mapping - P3,820.00
Free Fluid (FAST) - P 2,335.00
Thoracenthesis - P 4,790.00
Paracenthesis - P 4,790.00
Inguino - Scrotal - P 3,340.00
Inguinal - P 2,570.00
Scrotal (testes) - P2,570.00
Breast Core Needle Biopsy - P 3,175.00
Thyroid (FNAB) - P 3,175.00
OR & Portable UTZ Guided (Philips) - P858.82
TVS -P1,720.00
TVS - Pregnant Twin - P 2,245.00
Transrectal - P 1,705.00
Pelvic / Fetal Biometry - P1,140.00
Pelvic (Twin) - P1,705.00
Pelvic w/ Cervical Length Funneling - P1,720.00
BPS - P1,515.00
BPS (Twin) - P 2,710.00
BPS w/ Cervical Length Funneling - P 1,720.00
Congenital Anomaly - P 3,160.00
Folliculogram (follicle monitoring) - P1,705.00
OB Doppler - P2,420.00
Placental Doppler - P1,515.00
Gyne Color Mapping - P 2,420.00
Hysterosalpingosonogram - P 5,560.00
Salin Infusion Hysterosonogram - P5,560.00
SUBMIT
Kindly attach & upload your physicians prescriptions.
UPLOAD HERE
PROCEED TO STEP 2: SCHEDULE YOUR PREFERRED DATE
