01 17 - HIDROXIPROGESTERONA $180.00 010 ALDOLASA $90.00 0100 FERRITINA $130.00 0101 FRACCION BETA (CUANTITATIVA) $150.00 0102 FRUCTOSAMINA $195.00 0103 GAMMA GLUTAMILTRANSPEPTIDASA $90.00 0104 GLUCAGON $195.00 0105 GLUCOSA-6-FOSFATO DESHIDROGANASA $90.00 0106 GRASAS EN HECES $91.00 0107 HEMOGLOBINA GLICOSILADA $182.00 0108 AC. ANTI-HEPATITIS A (HAVA-M) $195.00 0109 AC. ANTI-HEPATITIS B (AG SUPERFICIE-AUSTRALIANO) $130.00 011 ALFAFETOPROTEINA $120.00 0110 AC. ANTI-HEPATITIS C (HCV) $260.00 0112 FIBRINOGENO $130.00 0113 HIDROXIPROLINA $325.00 012 AMONIO $150.00 013 ANFETAMINAS $90.00 014 ANTICOAGULANTE LUPICO $180.00 015 AC. ANTI-AMIBA $180.00 016 AC. ANTI-CARDIOLIPINAS IGG $135.00 0160 AC. ANTI-CARDIOLIPINAS IGM $135.00 017 AC. ANTI-CENTROMERO $195.00 018 AC. ANTI-CHLAMYDIA TRACHOMATIS $120.00 019 AC. ANTI-CISTICERCO EN LCR $150.00 02 17 - CETOSTEROIDES $182.00 020 AC. ANTI-CISTICERCO EN SUERO $150.00 021 AC. ANTI-CITOMEGALOVIRUS IGG $120.00 022 AC. ANTI-CITOMEGALOVIRUS IGM $120.00 023 AC. ANTI-DNA (DOBLE CADENA) $95.00 024 AC. ANTI-ENA $780.00 0240 AC. ANTI-FOSFOLIPIDOS IGG $260.00 0241 AC. ANTI-FOSFOLIPIDOS IGM $260.00 025 AC. ANTI-HELICOBACTER PYLORI IGG $120.00 026 AC. ANTI-HERPES I IGG $120.00 027 AC. ANTI-HERPES I IGM $120.00 028 AC. ANTI-HERPES II IGG $120.00 03 17 - HIDROXICORTICOSTEROIDES $180.00 030 AC. ANTI-EPSTEIN BARR IGG $301.00 0301 AC. ANTI-EPSTEIN BARR IGM $301.00 0302 AC. ANTI-EPSTEIN BARR (EA) TOTALES $301.00 032 AC. ANTI-MICROSOMALES $260.00 033 AC. ANTI-MITOCONDRIALES $260.00 034 AC. ANTI-MUSCULO LISO $260.00 035 AC. ANTI-MYCOPLASMA IGG $180.00 036 AC. ANTI-MYCOPLASMA IGM $180.00 038 AC. ANTI-NUCLEARES (CUALITATIVO) $120.00 039 AC. ANTI-NUCLEARES (CUANTITATIVO) $241.00 04 ACIDO FOLICO $195.00 040 AC. ANTI-RUBEOLA IGG $150.00 041 ACIDO VANILMANDELICO $180.00 0410 AC. ANTI-RUBEOLA IGM $150.00 043 AC. ANTI-SMITH $120.00 044 AC. ANTI-SSA (RO) $195.00 045 AC. ANTI-SSB (LA) $195.00 046 AC. ANTI-TIROGLOBULINA $260.00 047 AC. ANTI-TIROIDES (MICROSOMALES, TIROGLOBULINAS) $180.00 048 AC. ANTI-TOXOPLASMA IGG $120.00 Page 1 of 6
049 AC. ANTI-TOXOPLASMA IGM $120.00 05 ACIDO VALPROICO EN SANGRE $120.00 050 AC. ANTI-TREPONEMA PALLIDUM $260.00 051 AC. ANTI-HETEROFILOS (PAUL BUNELL) $150.00 052 AG. CARCINOEMBRIONARIO (CEA) $120.00 053 AG. PROSTATICO LIBRE $234.00 054 AG. PROSTATICO ESPECIFICO TOTAL $156.00 055 APOLIPOPROTEINAS A1 Y B $260.00 056 BARBITURICOS $105.00 057 BENZODIAZEPINAS $130.00 058 BETA 2 MICROGLOBULINA $260.00 059 CA 125 $225.00 060 CA 15-3 $225.00 061 CA 19-9 $225.00 062 CA 27-29 $748.00 063 CA 72-4 $748.00 064 CALCITONINA $260.00 065 CATECOLAMINAS( ADRENALINA, DOPAMINA, NORADRENALINA) $449.00 066 CANABINOIDES (MARIGUANA) $90.00 067 CAPTACION O FIJACION TOTAL DE HIERRO $130.00 068 CARBAMAZEPINA $120.00 069 CELULAS L.E. $75.00 070 CITOQUIMICO DE LIQUIDO BRONQUIAL $260.00 071 CITOQUIMICO DE L.C.R. $260.00 072 CITOQUIMICO DE L.ASCITISO-PERITO $260.00 0720 CITOQUIMICO DE L.DIALISIS $260.00 073 CITOQUIMICO DE L.PLEURAL $260.00 074 CITOQUIMICO DE L.SINOVIAL $260.00 076 CLONAZEPAM $180.00 077 COCAINA $90.00 078 COMPLEMENTO C2 $897.00 080 COMPLEMENTO C3 $90.00 081 COMPLEMENTO C4 $90.00 082 COMPLEMENTO HEMOLITICO 50% (TURBIOMETRIA) $180.00 083 COMPLEMENTO HEMOLITICO AL 100% $225.00 084 CORTISOL PLASMATICO $91.00 084A CORTISOL PLASMATICO (2 TOMAS) $210.00 085 CORTISOL URINARIO $105.00 086 CRIOAGLUTININAS $195.00 087 CRIOGLOBULINAS $195.00 088 DEHIDROEPIANDROSTERONA(DHE) $57.00 089 DEHIDROEPLANDROSTERONA SULFATO $105.00 09 ANDROSTERONA (ALDOSTERONA) $135.00 091 DOPAMINA $150.00 092 DIGOXINA $150.00 093 DIFENILHIDANTOINA $120.00 094 ELECTROFORESIS DE LIPOPROTEINAS (ORINA 24HRS) SOLO GRAFICA $150.00 095 ELECTROFORESIS DE LIPOPROTEINAS (SUERO) $169.00 095A ELECTROFORESIS DE LIPOPROTEINAS (ORINA 24HRS) $169.00 096 ESTRADIOL $120.00 097 ESTRIOL SERICO LIBRE $182.00 098 ESTROGENOS TOTALES $156.00 099 FENOBARBITAL $120.00 114 HORMONA ADRENOCORTICOTROFICA (ACTH) $120.00 115 HORMONA DE CRECIMIENTO $105.00 115A HORMONA DE CRECIMIENTO (2 TOMAS) $210.00 115B HORMONA DE CRECIMIENTO (5 TOMAS) $525.00 Page 2 of 6
116 HORMONA ESTIMULANTE DE TIROIDES $130.00 117 HORMONA FOLICULO ESTIMULANTE $130.00 118 HORMONA LUTEINIZANTE $130.00 119 HORMONA PARATIROIDEA ( PTH INTACTA) $120.00 120 INMUNOGLOBULINA A (SUERO) $90.00 120A INMUNOGLOBULINA A (ORINA 24HRS) $90.00 121 INMUNOGLOBULINA E (SUERO) $150.00 122 INMUNOGLOBULINA G (SUERO) $90.00 122A INMUNOGLOBULINA G (ORINA 24HRS) $90.00 123 INMUNOGLOBULINA M (SUERO) $90.00 123A INMUNOGLOBULINA M (ORINA 24HRS) $90.00 124 INSULINA BASAL $180.00 124A INSULINA BASAL (2 MED) $360.00 125 INSULINA POST PANDRIAL $120.00 126 AC.ANTI-CHLAMYDIA $156.00 127 AG MYCOPLASMA SP $156.00 128 LITIO SERICO $120.00 128A LITIO URINARIO $120.00 129 PLOMO $359.00 130 COBRE $359.00 131 MERCURIO $300.00 132 OSTEOCALCINA $325.00 133 PEPTIDO "C" $120.00 134 TRANSFERRINA O CAPTACION LIBRE DE HE $80.00 137 PANEL HEPATITIS A, B, C $585.00 138 PERFIL DE INMUNOGLOBULINAS $420.00 139 PERFIL DE TORCH COMPLETO IGG E IGM $1,170.00 1390 TORCH I SÓLO IGG $598.00 1391 TORCH II SÓLO IGM $598.00 140 PERFIL DE REPRODUCCION/GINECOLOGICO $520.00 141 PERFIL TIROIDEO $195.00 142 PERFIL SUPRARENAL(ACTH, CORTISOL, ALDOSTERONA) $346.00 144 PH Y AZUCARES REDUCTORES $104.00 145 PORFIRINAS $195.00 147 PROGESTERONA $130.00 148 PROLACTINA $130.00 149 PROTEINA DE BENCE JONES $75.00 150 SEROAMEBA $180.00 151 TESTOSTERONA LIBRE $114.00 152 TIEMPO DE TROMBINA $130.00 153 TIROGLOBULINA $130.00 155 VITAMINA B12 $150.00 156 AC. ANTI-TOXOCARA IGG $479.00 157 AC. ANTI-TOXOCARA IGM $479.00 158 FTA-ABS $0.00 160 VIRUS DE INMUNODEFICIENCIA ADQUIRIDA $120.00 163 DETERMINACIÓN DE METANEFRINA $897.00 165 PERFIL NEONATAL ( TAMIZ METABOLICO ) $0.00 167A SODIO URINARIO $90.00 167B POTASIO URINARIO $90.00 167C CLORO URINARIO $80.00 167D CALCIO URINARIO $80.00 167E FOSFORO URINARIO (24 HORAS) $80.00 167F CALCIO URINARIO (24 HRS) $80.00 167I CLORO SUDOR $155.00 167J SODIO URINARIO (24 HRS) $65.00 167K CLORO URINARIO (24 HRS) $65.00 167L POTASIO URINARIO (24HRS) $90.00 Page 3 of 6
169 CITOLOGIA EN MOCO FECAL $70.00 169A CITOLOGIA EN MOCO NASAL $34.00 171 RENINA PLASMATICA $598.00 172 INSULINA BASAL (3 MED) $540.00 173 ANTIDOPING $270.00 174 ANTI-CUERPOS ANTIESPERMA INMUNOBEADOS (IGA, IGG E IGM) $520.00 175 DIAZEPAN $260.00 176 ANTICUERPOS ANCA $520.00 178 ALBUMINA URINARIA (24 HRS) $22.00 180 MICROALBUMINURIA $50.00 181 PROLACTINA SERIADA (3 MUESTRAS) $390.00 182 TRIPLE MARCADOR CONGENITO $520.00 185 TESTOSTERONA TOTAL $114.00 185A TESTOSTERONA TOTAL (3 MUESTRAS) $342.00 186 ANDROSTEREDIONA $117.00 187 AC. ANTI-HERPES II IGM $120.00 188 PROTEINA C $1,560.00 189 PROTEINA S $1,560.00 190 INMUNOGLOBULINA D $325.00 191 ALFAGLUTAMIL TRANSFERASA $78.00 192 METALES PESADOS ( PLOMO, MERCURIO Y COBRE) $1,018.00 193 ELECTROFORESIS DE PROTEINAS LCR $150.00 195 PROTEINA C (% ACTIVADA) $2,541.00 196 AC. ANTI-PARVOVIRUS HUMANO B19 $910.00 197 AC. ANTI-PLAQUETARIOS $778.00 198 ESPERMACONTEO $0.00 199 BETACAROTENO EN SUERO $516.00 201 LACTOSA $90.00 202 SATURACION DE HIERRO $130.00 203 AC. ANTI-TUBERCULOSIS IGG $172.00 204 AC. ANTI-TUBERCULOSIS IGM $172.00 208 CICLOSPORINA $718.00 209 ELECTROFORESIS DE PROTEINAS (ORINA 24) $150.00 210 ELECTROFORESIS DE PROTEINAS (SUERO) $169.00 212 SAT $0.00 213 HORMONA TRANSPORTADORA DE ANDROGENOS $1,170.00 215 GOTA GRUESA $0.00 216 PROLACTINA SERIADA (2 MUESTRAS) $260.00 217 ROSA DE BENGALA $0.00 218 NIVELES SERICOS DE AMINOFILINA $260.00 220 ANTIPEROXIDASA $325.00 222 CAPACIDAD DE FIJACION DE HIERRO $130.00 223 EFE (SARAMPION, RUBEOLA Y ESCARLATINA) $0.00 224 FRAGILIDAD OSMOTICA $320.00 225 ELECTROFORESIS DE HEMOGLOBINA $910.00 226 DIMERO D $374.00 228 SARAMPION $0.00 228A SARAMPION (ORINA) $0.00 228B SARAMPION (FARINGEO) $0.00 228C SARAMPION (SUERO) $0.00 229 RUBEOLA $0.00 229A RUBEOLA (ORINA) $0.00 229B RUBEOLA (FARINGEO) $0.00 229C RUBEOLA (SUERO) $0.00 230 ESCARLATINA $0.00 230A ESCARLATINA (SUERO) $0.00 230B ESCARLATINA (FARINGEO) $0.00 232 ACIDO LACTICO $374.00 Page 4 of 6
234 DENGUE IGG E IGM $0.00 235 ANTIGENO CA 21.1 $972.00 237 FACTOR VIII $449.00 238 FACTOR IX $449.00 239 CITRATOS (ORINA 24HRS) $1,690.00 240 OXALATOS (ORINA 24HRS) $1,421.00 241 DNA NATIVO $1,196.00 243 COMPLEMENTO C 5 $1,495.00 244 CITOQUIMICO DE LITO $299.00 327 FACTOR VII $523.00 41 BIOMETRIA HEMATICA COMPLETA $90.00 412A TIEMPO DE SANGRADO $60.00 412B TIEMPO DE COAGULACION $60.00 413 TIEMPO DE PROTROMBINA $60.00 414 TIEMPO DE TROMBOPLASTINA $60.00 420 ACIDO URICO $40.00 421 BUN $50.00 422 GLUCOSA $50.00 423 CREATININA $50.00 425 CALCIO $80.00 426A CURVA DE TOLERANCIA A LA GLUCOSA DE 2 HRS $130.00 426B CURVA DE TOLERANCIA A LA GLUCOSA DE 3 HRS $180.00 426C GLUCOSA POSTPANDRIAL $120.00 426D CURVA DE TOLERANCIA A LA GLUCOSA 1 HR $69.00 427 CURVA DE TOLERANCIA A LA GLUCOSA 5 TOMAS $230.00 427A CURVA DE TOLERANCIA A LA GLUCOSA (6 TOMAS) $245.00 428 COLESTEROL $80.00 4280 COLESTEROL DE ALTA DENSIDAD $80.00 4281 COLESTEROL DE BAJA DENSIDAD $80.00 430 PROTEINAS TOTALES ( ALBUMINA Y GLUBULINA) $100.00 431 TRIGLICERIDOS $80.00 432 ALBUMINA $40.00 437 CLORO SERICO $55.00 438A SODIO $90.00 438B MAGNESIO $90.00 438C HIERRO SERICO $126.00 438D MAGNESIO URINARIO $169.00 439A POTASIO $90.00 439B FOSFORO $80.00 441 BILIRRUBINAS $80.00 442 TRANSAMINASA GLUTAMICO OXALACETICA $80.00 443 TRANSAMINASA GLUTAMICO PIRUVICA $80.00 444 FOSFATASA ACIDA $90.00 4440 FRACCION PROSTATICA $122.00 445 FOSFATASA ALCALINA $90.00 446 LIPASA $90.00 4460 AMILASA SERICA $70.00 449 VDRL $60.00 45 VEL. SED. GLOBULAR $40.00 450 REACCIONES FEBRILES $90.00 4501 DOS MERCAPTO ETANOL $0.00 451 EOSINOFILOS EN MOCO NASAL $80.00 454 PRUEBA INMUNOLOGICA DE EMBARAZO $70.00 CUANTIFICACION DE HORMONA GONADOTROFINA CORIONICA HUMANA (24 HRS) $160.00 455 456 ANTIESTREPTOLISINAS $80.00 457 PROTEINA C REACTIVA $60.00 458 FACTOR REUMATOIDE $60.00 Page 5 of 6
459 EXAMEN GENERAL DE ORINA $60.00 46 RETICULOCITOS $50.00 464 ESPERMATOBIOSCOPIAS $120.00 465 COPROLOGICO $80.00 466 COPROPARASITOSCOPICO I $40.00 467 COPROPARASITOSCOPICO III $90.00 468 AMIBA EN FRESCO $30.00 4680 PRUEBA DE GRAHAM $50.00 4681 KATO-KATS $70.00 469 SANGRE OCULTA EN HECES $50.00 4801 DEPURACION DE CREATININA $100.00 4802 CUANTIFICACION DE PROTEINAS TOTALES $60.00 4803 CUANTIFICACION DE ACIDO URICO $60.00 4804 DEPURACION DE UREA $100.00 4805 GLUCOSA URINARIA $50.00 4806 UREA URINARIA $60.00 4807 CREATININA URINARIA $50.00 4808 ACIDO URICO URINARIO (24HRS) $52.00 4809 PROTEINAS EN ORINA (24 HRS) $60.00 480A PROTEINAS EN ORINA (12 HRS) $60.00 480B PROTEINURIA $28.00 483 DESHIDROGENASA LACTICA $90.00 4830 CREATIN FOSFO QUINASA $90.00 4831 CREATINFOSFOQUINASA FRACCION MB $90.00 49 GRUPO SANGUINEO $60.00 491 COLINESTERASA $143.00 50 CHAGAS $0.00 51 ERITROPOYETINA $1,300.00 52 ESTRONA $520.00 53 GLICOPROTEINAS $500.00 54 ACS ANTIBETA2 GLICOPROTEINA $449.00 55 AC. ANTI-RECEPTOR DE ACETILCOLINA $748.00 56 VON WILYBRAN $897.00 57 SERULOPLASMINA $688.00 58 AG HLA-B27 $897.00 60 SOMATOMEDINA C $598.00 600 PC-PRUEBAS DE FUNCION HEPATICA $520.00 602 PC-PERFIL REUMATICO $280.00 603 PC-PRENUPCIALES $120.00 604 PC-QUIMICA SANGUINEA 6 $350.00 605 PC-QUIMICA SANGUINEA 3 $150.00 606 PC-PERFIL DE LIPIDOS $320.00 607 PC-PROTOCOLO DE TRANSPLANTE RENAL $1,232.00 608 PC-CERTIFICADO MEDICO $240.00 609 PC-PRENATAL $320.00 61 IGF-BP-3 (FRACCION SOMATOMEDINA) $1,196.00 90 PAQUETE SEMINARIO $114.00 SGT CONVENIO SGT $240.00 Page 6 of 6