St Paul Hospital Cavite Inc.
Evangelizing through SPHC Healthcare Services
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X-ray Forms
* 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 X-ray Procedure (estimated)
Chest PA - P535.00
Chest AP - P535.00
Chest PA/L or AP/L - P935.00
Chest Lateral Decubitus - P535.00
Portable Chest AP - P590.00
Portale Chest AP/L - P1,030.00
T-Cage/Chest Bucky - P510.00
Apico - P250.00
Spot Film - P250.00
Babygram AP/L - P1,780.00
Portable Babygram AP/L - P1,950.00
Plain Abdomen - P665.00
Plain Abdomen (supine/upright) - P1,330.00
Skull AP/L - P840.00
Soft Tisse Lateral -P840.00
Pelvis AP - P535.00
Pelvis (Inlet & Outlet) - P1,070.00
Pelvis AP/Frogleg -P1,070.00
AP/ HIP (x-table lateral) - P1,070.00
Skeletal Survey - P11,980.00
Arm(Humerus) AP/L - P600.00
Bilateral Arm AP/L - P1,200.00
Elbow AP/L - P600.00
Elbow Greenspan - P600.00
Bilateral Elbow AP/L - P1,200.00
Elbow (jones/greenspan) - P600.00
Digits AP/L - P600.00
Forearm AP/L - P600.00
Bilateral Forearm AP/L - P1,200.00
Hand AP/L - P600.00
Hand AP/O - P600.00
Bilateral Hand AP/L - P1,200.00
Bilateral Hand AP/O - P1,200.00
Clavicle AP - P660.00
Shoulder AP/Y - P600
Shoulder Grashey - P600.00
Bilateral Shoulder AP/Y - P1,200.00
Shoulder APL (int. & ext. rotation) - P1,200.00
Wrist AP/L - 600.00
Bilateral Wrist AP/L - P1,200.00
Wrist Bone Aging - P800.00
Ankle AP/L - P720.00
Ankle AP/Mortise - P720.00
Bilateral Ankle AP/L - P1,440.00
Ankle Mortise AP/L - P1,080.00
Calcaneal Axial & Lateral - P720.00
Femur - P720.00
Bilateral Femur - P1,440.00
Foot AP/L - P720.00
Foot AP/O - P720.00
Foot AP/OBL/L - P1,80.00
Bilateral Foot AP/OBL/L - P2,160.00
Bilateral Foot AP/OBL - P1,440.00
Knee AP/L - P720.00
Bilateral Knee AP/L - P1,440.00
Knee sunrise/tunnel - P720.00
Bilateral Knee sunrise/tunnel - P1,440.00
Leg APL - P720.00
Bilateral Leg AP/L - P1,440.00
Cervical AP/L - P985.00
Cervical APOL / OM - P1,975.00
Lumbosacral APL - P1,135.00
Lumbosacral APL/OB/L - P2,195.00
Thoracic Spine APL - P1,135.00
Thoracolumbar AP/L -P1,135.00
Thoracolumbar R&L Bending - P2,260.00
ThoracoLumbarSacral AP/L - P 2,260.00
Sacrum & Coccyx AP/L - P720.00
Whole Spine - P2,535.00
Water's View - P720.00
Town's View P720.00
TMJ - P1,675.00
Mandible (per shot) - P720.00
Nasal Bone STOL + Waters - P1,265.00
Paarnasal Sinuses - P1,265.00
Zygomatic Bones - P600.00
Mastoid Series - P1,390.00
Portable ORIF - P720.00
Pelvimetry - P2,405.00
SUBMIT
Kindly attach & upload your physicians prescriptions.
UPLOAD HERE
PROCEED TO STEP 2: SCHEDULE YOUR PREFERRED DATE