CGHS DELHI 2010 RATES AND EMPANELLED DIAGNOSTIC LABORATORIES AND IMAGING CENTRES S.No.

NAME OF INVESTIGATION For Delhi NABL Accredited For Delhi Non NABL in in Rupees DENTAL 1 Dental IOPA X ray 2 Occlusal X ray 3 OPG X ray PULMONARY 4 Lung Ventilation & Perfusion Scan (V/Q Scan) 5 Lung Perfusion Scan OSTEOLOGY 6 Whole Body Bone Scan with SPECT. 7 Three phase whole body Bone Scan NEUROSCIENCES 8 Brain Perfusion SPECT Scan with Technetium 99m radiopharmaceuticals. 9 Radionuclide Cisternography for CSF leak GASTRO AND HEPATOBILIARY 10 Gastro esophageal Reflux Study (G.E.R. Study) 11 Gastro intestinal Bleed (GloB.) Study with Technetium 99m labeled RBCs. 12 Hepatobiliary Scintigraphy. 13 Meckel's Scan 14 Hepatosplenic scintigraphy with Technetium 99m radiopharmaceuticals 15 Gastric emptying GENITOURINARY 16 Renal Cortical Scintigraphy with Technetium 99m D.M.S.A. 17 Dynamic Renography. 18 Dynamic Renography with Diuretic. 19 Dynamic Renography with Captopril 20 Testicular Scan ENDOCRINOLOGY 21 Thyroid Uptake measurements with 131 Iodine. 22 Thyroid Scan with Technetium 99m Pertechnetate. 23 lodine 131 Whole Body Scan. 24 Whole Body Scan with M.I.B.G. 25 Parathyroid Scan RADIO ISOTOPE THERAPY 26 131 lodine Therapy 27 131 lodine Therapy <15mCi 28 131 lodine Therapy 15 50mCi 29 131 lodine Therapy 51 100mCi 30 131 lodine Therapy >100mCi 31 Phosphorus 32 therapy for metastatic bone pain palliation 32 Samarium 153 therapy for metastatic bone pain palliation 33 Radiosynovectomy with Yttrium CARDIOLOGY 34 Stress thallium / Myocardial Perfusion Scintigraphy 35 Rest thallium / Myocardial Perfusion Scintigraphy 36 Venography 37 ECG 70 80 200 5,000 3,000 3,500 3,500 10,000 5,000 2,000 3,500 2,500 2,000 2,500 1,500 3,500 3,500 3,500 4,500 1,500 1,600 1,500 3,000 18,000 5,000 Listed under Treatment Listed under Treatment Listed under Treatment Listed under Treatment Listed under Treatment Listed under Treatment Listed under Treatment Listed under Treatment 9,900 9,900 3,500 50 Rupees

60 68 170 4,250 2,550 2,975 2,975 8,500 4,250 1,700 2,975 2,125 1,700 2,125 1,275 2,975 2,975 2,975 3,825 1,275 1,360 1,275 2,550 15,300 4,250

8,415 8,415 2,975 43

38 39 40 41 42 43 44 45 46 47 48

49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84

STRESS ECHO DOBUTAMINE STRESS ECHO EXERCISE TMT TEE Lymph angiography TUMOUR IMAGING Scintimammography. Indium lableled octeriotide Scan. PET SCAN FDG Whole body PET / CT Scan Brain I Heart FDG PET / CTScan, Gallium 68 Peptide PET / CT imaging for Neuroendocrine Tumor Non FDG PET / CT Scan Laboratory Medicine Clinical Pathology Urine routine pH,Specific gravity,sugar,protein and microscopy 24 hrs urine for Proteins,Sodium,creatinine Urine Microalbumin Quantitative Albumin/Sugar Urine Bile Pigment and Salt Urine Urobilinogen Urine Ketones Urine Occult Blood Urine total proteins Bence Jones protein Stool routine Stool occult blood Post coital smear examination semen analysis Body fluid (CSF/Ascitic Fluid etc.)Sugar, Protein etc. Albumin. Creatinine clearance. Haematology Haemoglobin (Hb) Total Leucocytic Count (TLC) Differential Leucocytic Count (DLC) E.S.R. Total Red Cell count with MCV,MCH,MCHC,DRW Complete Haemogram Hb,RBC count and indices, TLC, DLC, Platelet, ESR, Platelet count Reticulocyte count Absolute Eosinophil count Packed Cell Volume (PCV) Peripheral Smear Examination Smear for Malaria parasite Bleeding & Clotting Time Clot Retraction Time R.B.C. Fragility Test L.E. Cell Foetal Haemoglobin (Hb F) Prothrombin Time (P.T.) Bone Marrow Smear Exmination

Listed under Treatment 1,650 500 500 1,650 5,000 75,000 21,000 15,000 17,000

1,403 425 425 1,403 4,250 63,750 17,850 12,750 14,450

39 100 150 24 35 35 35 35 21 48 39 35 100 80 100 21 160 19 32 32 35 35 138 50 49 50 35 44 42 48 35 60 77 154 119 75

33 85 128 20 30 30 30 30 18 41 33 30 85 68 85 18 136 16 27 27 30 30 117 42 42 42 30 37 36 41 30 51 65 131 101 64

85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129

Bone Marrow Smear Exmination with iron stain Bone Marrow Smear Exmination and cytochemistry where required. Partial Thromboplastin Glucose Phosphate Dehydrogenase (G, 6PD) Rapid test for malaria(card test) WBC cytochemistry for leukemia Conmplete panel Bleeding Disorder panel BT,CT,Platetlet count,APTT,extended & Dic Factro Assays Factor VIII Factor Assays Factor IX Factro Assays other Factors Anti Cardiolipin Antibodies. IgG. IgM. IgA. Anti Phospholipid Antibodies. IgG. IgM. IgA. Thalessemia studies Hb Electrophoresis Sickling studies Nutritional Markers Serum Iron Total Iron Binding Capacity Vitamin B.12. Folic Acid. HDL Cholestrol Blood Bank Blood Group & RHO Type Cross match Packed cell preparation Coombs Test Direct Coombs Test Indirect Australia Antigen RHO, Antibody titer Blood Components PRO Blood Components Fresh Frozen Plasma Blood Components Cryoprecipitate Histopathology Routine H & E special stain Immunohistochemistry(IHC) Frozen section Paraffin section Cytology Pap Smear Vaginal Cytology for Hormonal evaluation Body fluid for Malignant cells FNAC special stain on cytology Flow cytometry Leukemia panel /Lymphoma panel

256 665 105 250 44 890 700 750 700 2,763 260 260 260 260 260 260 700 455 77 100 100 256 350 100 33 60 40 100 119 120 119 2,800 3,800 488 100 100 878 1,500 350 160 160 200 250 90 3,575

218 565 89 213 37 757 595 638 595 2,348 221 221 221 221 221 221 595 387 65 85 85 218 298 85 28 51 34 85 101 102 101 2,380 3,230 414 85 85 746 1,275 298 136 136 170 213 77 3,039

130 CD Count: CD3,CD4,CD8 131 PNH Panel CD55,CD59 Cytogenetics 132 karyotyping Tumour markers. 133 PSA Total. 134 PSA Free. 135 AFP. 136 HCG. 137 CA. 125. 138 CA 19,9. 139 CA 5,3. 140 Carcioembryonic antigen(CEA) Bio Chemistry 141 Blood Glucose Random 142 Blood Urea Nitrogen 143 Serum Creatinine 144 Serum Uric Acid 145 Serum Bilirubin total & direct 146 Serum Iron 147 Serum Cholesterol 148 Total Iron Binding Capacity 149 Glucose (Fasting & PP) 150 Serum Calcium Total 151 Serum Calcium Ionic 152 Serum Phosphorus 153 Total Protein Alb/Glo Ratio 154 S.G.P.T. 155 S.G.O.T. 156 Serum amylase 157 Serum Electrolyte 158 Triglyceride 159 Glucose Tolerance Test (GTT) 160 C.P.K. 161 L.D.H. 162 Alkaline Phosphatase 163 Acid Phosphatase 164 CK MB 165 Lithium. 166 Dilantin (phenytoin). 167 Carbamazepine. 168 Valproic acid. 169 Feritin. 170 Blood gas analysis 171 Blood gas analysis with electrolytes 172 Urine pregnancy test 173 Hb A1 C 174 Kidney Function Test. 175 Liver Function Test. 176 Lipid Profile.( Total cholesterol,LDL,HDL,treigylcerides) 177 Extended Lipid Profile.( Total cholesterol,LDL,HDL,treigylcerides,Apo A1,Apo 178 Apo A1.

1,000 1,450 2,200 319 450 345 340 400 630 630 350 25 55 56 56 100 63 100 48 63 45 66 70 56 56 120 140 95 100 105 132 63 80 196 140 439 439 315 315 470 151 69 165 261 275 215 700 203

850 1,233 1,870 271 383 293 289 340 536 536 298 21 47 48 48 85 54 85 41 54 38 56 60 48 48 102 119 81 85 89 112 54 68 167 119 373 373 268 268 400 129 58 140 222 234 182 595 173

179 180 181 182 183 184 185 186 187 188 189 190 191 192 193 194 195 196 197 198 199 200 201 202 203 204 205 206 207 208 209 210 211 212 213 214 215 216 217 218 219 220 221 222 223 224 225 226 227 228

Apo B. Lp (a). LDL. Homocysteine. HB Electrophoresis. Serum Electrophoresis. Fibrinogen. Chloride. Magnesium. GGTP. Lipase. Fructosamine. 2 microglobulin Albumin. Catecholamines. Creatinine clearance. Harmones T3, T4, TSH T3 T4 TSH LH FSH Prolactin Cortisol Enteropoetin PTH(Paratharmone) Calcitonin C Peptide. Insulin. Progesterone. 17 DH Progesterone. DHEAS. Androstendione. Growth Hormone. TPO. Throglobulin. Microbiology & Serology Smear gram strain examination Sputum smear A.F.B. stain Vaginal Smear Examination Direct smear and stain examination for cryptosporidium Direct smear and stain examination for P.Carcinei LCB Count for mycology LCB Count for others V.D.R.L. TPHA test Widal test Rheumatoid Factor test Culture & Sensitivity bacterial Culture & Sensitivity Mycobacterial Culture & Sensitivity mycology

203 455 63 455 450 300 400 66 154 100 245 224 100 21 1,400 160 213 75 75 125 188 188 188 266 693 618 840 400 325 266 450 450 770 350 385 400 48 56 80 100 100 150 300 50 210 70 105 100 200 200

173 387 54 387 383 255 340 56 131 85 208 190 85 18 1,190 136 181 64 64 106 159 159 159 226 589 525 714 340 276 226 383 383 655 298 327 340 41 48 68 85 85 128 255 42 179 60 89 85 170 170

229 230 231 232 233 234 235 236 237 238 239 240 241 242 243 244 245 246 247 248 249 250 251 252 253 254 255 256 257 258 259 260 261 262 263 264 265 266 267 268 269 270 271 272 273

C.R.P. C.R.P Quantative ASO Titer Quantitative H.C.G. Blood culture & sensitivity manual Blood culture & sensitivity automated Vibro cholera culture Rapid Blood Culture. Rapid AFB Culture. C.3. C.4. IgG. IgM. IgA. ANA. Ds DNA. P ANCA. C ANCA. Infectuous disease serology HAV. HbSAg Elisa. Anti HBS. Anti HBC Total. Anti HBC IgM. HbeAg. Anti Hbe. Anti HCV. Anti HEV. Triple Marker. TORCH. IgG. IgM. Toxoplasmosis. IgG. IgM. CMV(Cytomegalo virus). IgG. IgM. HSV. IgG. IgM. IgE. Tuberculosis TB IgG. TB IgM. TB IgA. Rubella Ig G Ig M Ig A Dengue Serology. Cysticercosis.

120 200 143 80 160 300 300 468 420 250 250 260 260 260 320 385 800 770 553 147 300 490 488 423 450 400 618 900 260 260 260 260 260 260 260 260 400 280 280 280 200 200 250 600 500

102 170 122 68 136 255 255 397 357 213 213 221 221 221 272 327 680 655 470 125 255 417 414 359 383 340 525 765 221 221 221 221 221 221 221 221 340 238 238 238 170 170 213 510 425

274 Hydatic Serology. 275 Anti Sperm Antibodies. HBV DNA. 276 Qualitative. 277 Quantitative. HCV RNA. 278 Qualitative. 279 HPV serology 280 Rota Virus serology 281 PCR for TB 282 PCR for HIV 283 Chlamydae antigen 284 chlamydae antibody 285 Brucella serology 286 Influenza A serology USG, X ray , CT, MRI, Bone Densitometry 287 USG for Obstetrics Anomalies scan 288 Abdomen USG 289 Pelvic USG ( prostate, gynae, infertility etc) 290 Small parts USG ( scrotum, thyroid , parathyroid etc) 291 Neonatal head (Tranfontanellar) 292 Neonatal spine 293 Contrast enhanced USG 294 USG Breast 295 USG Hystero Salpaingography (HSG) 296 Colour Doppler , Carotid artery 297 Colour Doppler, Peripheral Artery/Veins 298 Colour doppler, renal arteries/any other organ 299 USG guided intervention aspiration 300 USG guided intervention FNAC 301 USG guided intervention biopsy 302 USG guided intervention nephrostomy X Ray 303 Abdomen AP Supine or Erect (One film) 304 Abdomen Lateral view (one film) 305 Pelvimetry 306 Chest PA view (one film) 307 Chest Lateral (one film) 308 Mastoids: Towne view, oblique views (3 films) 309 Extremities, bones & Joints AP & Lateral views (Two films) 310 Pelvis A.P (one film) 311 T. M. Joints (one film) 312 Abdomen & Pelvis for K. U. B. 313 Skull A. P. & Lateral (2 films) 314 Spine A. P. & Lateral (2 films) 315 PNS view (1 film) X ray Contrast studies 316 Barium Swallow 317 Barium Upper GI study 318 Barium Upper GI study (Double contrast) 319 Barium Meal follow through 320 Barium Enema (Single contrast/double contrast)

374 406 2,340 1,600 2,340 163 975 630 900 280 245 943 380 300 300 410 500 500 1,000 410 300 1,000 830 1,000 500 700 Listed under Treatment 875 150 150 150 70 70 300 300 150 150 150 300 300 150 600 1,000 1,100 1,100 1,000

318 345 1,989 1,360 1,989 138 829 536 765 238 208 801 323 255 255 349 425 425 850 349 255 850 706 850 425 595 744 128 128 128 60 60 255 255 128 128 128 255 255 128 510 850 935 935 850

321 322 323 324 325 326 327 328 329 330 331 332 333 334 335 336 337 338 339 340 341 342 343 344 345 346 347 348 349 350 351 352 353 354 355 356 357 358 359 360 361 362 363 364 365 366 367 368 369

Small bowel enteroclysis ERCP (Endoscopic Retrograde Cholangio Pancreatography) General :Fistulography /Sinography/Sialography/Dacrocystography/ T Tube Percutaneous transhepatic cholangiography (PTC) Intravenous Pyelography (IVP) Micturating Cystourethrography (MCU) Retrograde Urethrography (RGU) Contrast Hystero Salpingography (HSG) X ray Arthrography Cephalography Myelography Digital Subtraction Angiography (DSA) Cerebral arteries Digital Subtraction Angiography (DSA) Peripheral Artery/arteries Digital Subtraction Angiography (DSA) abdomen Digital Subtraction Angiography (DSA) chest Mammography X ray Mammography Ultrasound Mammography MRI Mammography CT CT Head Without Contrast CT Head with Contrast (+/ CT angiography) C. T. Chest without contrast (for lungs) C. T. Chest with contrast (+/ CT angiography) C. T. Scan Upper Abdomen Without Contrast C. T. Scan Upper Abdomen With Contrast C. T. Scan Lower Abdomen Without Contrast C. T. Scan lower Abdomen With Contrast C. T. Scan Whole Abdomen Without Contrast C. T. Scan Whole Abdomen With Contrast CT angiography abdomen CT enteroclysis C. T. Scan Neck (Thyroid, parathyroid, Soft Tissues) Without Contrast C. T. Scan Neck With Contrast C. T. Scan Orbits Without Contrast C. T. Scan Orbits With Contrast C. T. Scan of Para Nasal Sinuses Without Contrast C. T. Scan of Para Nasal Sinuses With Contrast C. T. Spine (Cervical, Dorsal, Lumbar, Sacral)without contrast CT Temporal bone without contrast CT Dental C. T. Scan Limbs Without Contrast C. T. Scan Limbs With Contrast including CT angiography C.T. Guided intervention Biopsy /FNAC C. T. Guided intervention percutaneous catheter drainage / tube placement MRI MRI Head Without Contrast MRI Head With Contrast MRI Orbits Without Contrast MRI Orbits With Contrast MRI Nasopharynx and PNS Without Contrast MRI Nasopharynx and PNS With Contrast

1,200 6,010 750 1,500 1,400 800 800 1,200 2,400 150 3,500 22,000 9,000

1,020 5,109 638 1,275 1,190 680 680 1,020 2,040 128 2,975 18,700 7,650

500 500 3,000 1,050 1,350 2,000 2,500 1,700 2,400 1,700 2,400 3,300 4,500 5,000 7,500 1,800 2,200 1,400 1,900 1,250 2,100 1,750 1,050 1,500 2,000 2,650 1,500 1,535 2,350 3,350 1,700 5,000 2,500 5,000

425 425 2,550 893 1,148 1,700 2,125 1,445 2,040 1,445 2,040 2,805 3,825 4,250 6,375 1,530 1,870 1,190 1,615 1,063 1,785 1,488 893 1,275 1,700 2,253 1,275 1,305 1,998 2,848 1,445 4,250 2,125 4,250

370 371 372 373 374 375 376 377 378 379 380 381 382 383 384 385 386 387 388 389 390 391 392 393 394 395 396 397 398 399 400 401 402 403 404 405 406 407 408 409 410 411 412 413 414 415 416 417 418 419

MRI Neck Without Contrast MRI Neck with contrast MRI Shoulder With contrast MRI Shoulder Without contrast MRI shoulder both Joints Without contrast MRI Shoulder both joints With contrast MRI Wrist Single joint Without contrast MRI Wrist Single joint With contrast MRI Wrist both joints Without contrast MRI Wrist Both joints With contrast MRI knee Single joint Without contrast MRI knee Single joint With contrast MRI knee both joints Without contrast MRI knee both joints With contrast MRI Ankle Single joint Without contrast MRI Ankle single joint With contrast MRI Ankle both joints With contrast MRI Ankle both joints Without contrast MRI Hip With contrast MRI Hip without contrast MRI Pelvis Without Contrast MRI Pelvis with contrast MRI Extremities With contrast MRI Extremities Without contrast MRI Temporomandibular Single Joint With contrast MRI Temporomandibular Single Joint Without contrast MRI Temporomandibular Double Joint With contrast MRI Temporomandibular Double Joint Without contrast MRI Abdomen Without Contrast MRI Abdomen With Contrast MRI Breast With Contrast MRI Breast Without Contrast MRI Spine Screening Without Contrast MRI Chest Without Contrast MRI Chest With Contrast MRI Cervical Spine Without Contrast MRI Cervical Spine With Contrast MRI Dorsal Spine Without Contrast MRI Dorsal Spine With Contrast MRI Lumbar Spine Without Contrast MRI Lumbar Spine With Contrast Whole body MRI (For oncological workup) MRI Angiography Without Contrast MRI Angiography With Contrast MR cholecysto pancreatography. MR Enteroclysis Bone Densitometry Bone Densitometry Single Site Bone Densitometry Two sites Bone Densitometry Three sites (Spine, Hip & extremity) Bone Densitometry Whole body NEUROLOGICAL INVESTIGATIONS AND PROCEDURES

2,400 5,000 2,500 3,000 2,500 5,000 2,500 5,000 2,500 5,000 2,500 5,000 2,500 5,000 2,500 5,000 2,500 3,000 2,500 3,000 2,500 5,000 5,000 2,500 5,000 2,500 5,000 2,500 2,500 5,000 5,000 2,500 1,000 2,500 5,000 2,500 5,000 2,500 5,000 2,500 5,000 6,000 1,200 5,000 2,500 2,500 1,000 1,800 2,300 2,950

2,040 4,250 2,125 2,550 2,125 4,250 2,125 4,250 2,125 4,250 2,125 4,250 2,125 4,250 2,125 4,250 2,125 2,550 2,125 2,550 2,125 4,250 4,250 2,125 4,250 2,125 4,250 2,125 2,125 4,250 4,250 2,125 850 2,125 4,250 2,125 4,250 2,125 4,250 2,125 4,250 5,100 1,020 4,250 2,125 2,125 850 1,530 1,955 2,508

420 EEG/Video EEG 421 EMG (Electro myography) 422 Nerve condition velocity (at least 2 limbs) 423 Decremental response (before and after neo stigmine) 424 Incremental response 425 SSEP (Somato sensory evoked potentials) 426 Poly somnography 427 Brachial plexus study 428 Muscle biopsy 429 ACHR anti body titre 430 Anti MUSK body titre 431 Serum COPPER 432 Serum ceruloplasmin 433 Urinary copper 434 Serum homocystine 435 Serum valproate level 436 Serum phenol barbitone level 437 Coagulation profile 438 Protein C, S anti thrombine III 439 Serum lactate level CSF 440 a. Basic studies including cell count, protein, sugar, gram stain, India Ink 441 b. Special studies 442 PCR for tuberculosis/ Herpes simplex 443 Bacterial culture and sensitivity 444 Mycobacterial culture and sensitivity 445 Fungal culture 446 Malignant cells 447 Anti measles antibody titre (with serum antibody titre) 448 Viral culture 449 Antibody titre (Herpes simplex, cytomegalo virus, flavivirus, zoster varicella 450 Oligoclonal band 451 Myelin Basic protein 452 Lactate 453 Crypto coccal antigen TESTS IN GASTRO ENTEROLOGY 454 a. D xylase test 455 b. Fecal fat test/ fecal chymotrypsin/ fecal elastase 456 c. Breath tests 457 d. H pylori serology for ciliac disease 458 e. HBV genotyping 459 f. HCV genotyping Tests in Endocrinology ( in addition to those included under Harmones) 460 Urinary VMA 461 Urinary metanephrine/Normetanephrine 462 Urinary free catecholamine 463 Serum catecholamine 464 Serum aldosterone 465 24 Hr urinary aldosterone 466 Plasma renin activity 467 Serum aldosterone/renin ratio 468 Osmolality urine

350 750 750 700 700 750 750 750 450 8,500 9,500 600 618 600 455 439 390 650 5,558 540 240 1,200 1,229 200 200 150 75 1,230 300 2,275 1,500 5,040 350 1,138 1,200 1,200 1,500 550 2,730 5,450 1,500 1,138 1,690 3,500 1,200 920 1,235 1,250 150

298 638 638 595 595 638 638 638 383 7,225 8,075 510 525 510 387 373 332 553 4,724 459 204 1,020 1,044 170 170 128 64 1,046 255 1,934 1,275 4,284 298 967 1,020 1,020 1,275 468 2,321 4,633 1,275 967 1,437 2,975 1,020 782 1,050 1,063 128

469 470 471 472 473 474 475 476 477 478 479 480 481 482 483 484 485 486 487 488 489 490

Osmolality serum Urinary sodium Urinary Chloride Urinary potassium Urinary calcium Anti TPO ante body Thyroid binding globulin Serum cotisole 24 hr urinary free cotisole Islet cell antebody GAD antibody Insulin associated antibody IGF 1 IGF BP3 Sex hormone binding globulin USG guided FNAC thyroid gland FT3 FT4 FT4/TSH FT3/FT4/TSH E2 Thyro globulin antibody

150 94 50 94 94 400 600 300 400 1,015 1,330 449 2,015 1,788 1,333 455 125 125 100 300 245 700

128 79 43 79 79 340 510 255 340 863 1,131 381 1,713 1,519 1,133 387 106 106 85 255 208 595