as of March 2017
| SERVICES | RATE |
|---|---|
| Carotid Angiography | 800.00 |
| Carotid Arteriography | 800.00 |
| Cholangiogram (T-Tube) | 400.00 |
| Cholangiography (Oral) | 800.00 |
| Colonogram (Adult) | 400.00 |
| Colonogram (Pedia) | 350.00 |
| Cysto-RGP | 800.00 |
| Esophagogram | 400.00 |
| Fistulogram | 400.00 |
| Gastro-Intestine Series (UGIS) | 800.00 |
| Hysterosalphingography | 800.00 |
| Intravenous Pyelography | 800.00 |
| Nephrogram | 450.00 |
| Oral Cholecystography | 1,200.00 |
| Percutaneous Transhepatic Cholangiogram | 800.00 |
| Sialography | 800.00 |
| Small Intestinal Series | 800.00 |