CATALOGO DE PRESTACIONES CLINICA BUPA ANTOFAGASTA

CATALOGO DE PRESTACIONES CLINICA BUPA ANTOFAGASTA 2016 Horario hábil: Lunes a Viernes de 08:00 horas hasta las 20:00 horas y Sábados de 08:00 horas hasta las 13:00 horas (con excepción de los días festivos). Horario : Recargo para prestaciones según se indica. El valor de Isapre corresponde a un valor referencial sujeto a variación según lo que disponga para la prestación respectiva el plan de Isapre del paciente. CODIGO DESCRIPCION Habil 1010 Otras Atenciones Habil 713103 Visita por médico interconsultor habil $78.043 $78.043 $77.055 $77.055 $78.043 $78.043 713102 Visita por médico interconsultor inhábil $94.371 $94.371 $93.971 $93.971 $94.371 $94.371 101001 Consulta Medica electiva o de urgencia $11.060 $11.060 n.a. n.a. n.a. n.a. 104008 Atencion de Urgencia (Horario Hábil); inc. Triage n.a. n.a. $37.363 n.a. $41.292 n.a. 104009 Atencion de Urgencia (Horario ); inc. Triage n.a. n.a. n.a. $45.162 n.a. $49.892 104017 Categorización (Triage) $18.255 $18.255 n.a. n.a. n.a. n.a. 103001 Consulta Matrona $11.495 $11.495 $10.162 $10.162 $11.495 $11.495 2603009 Curaciones Planas $12.892 $12.892 $12.451 $12.451 $12.892 $12.892 2603502 Curaciones Irrigadas Y Quemadu $16.871 $16.871 $16.282 $16.282 $16.871 $16.871 2603503 Tratamientos Inyectables $8.216 $8.216 $7.923 $7.923 $8.216 $8.216 2603504 Lavado Y Extrac.De Cuerpo Extr $29.601 $29.601 $28.576 $28.576 $29.601 $29.601 2603679 Instalacion Sonda Nasogastrica $17.893 $17.893 $13.960 $13.960 $17.893 $17.893 2603608 Nebulizaciones $11.430 $11.430 $11.029 $11.029 $11.430 $11.430 2603022 Fleboclisis $19.111 $19.111 $18.445 $18.445 $19.111 $19.111 2603509 Colocación Valva De Yeso $6.202 $6.202 $5.994 $5.994 $6.202 $6.202 2603510 Sutura Menor $36.453 $36.453 $35.193 $35.193 $36.453 $36.453 2603513 Hemoglutest $5.569 $5.569 $5.369 $5.369 $5.569 $5.569 2603514 Retiro De Yeso $7.696 $7.696 $7.431 $7.431 $7.696 $7.696 2603628 Retiro De Puntos $6.462 $6.462 $6.240 $6.240 $6.462 $6.462 2603520 Vaciamiento Vasical Por Sonda $18.689 $18.689 $18.040 $18.040 $18.689 $18.689 1010 Ambulancia 2401533 Ambulancia (Viaje Ida) $59.372 $59.372 $57.935 $57.935 $59.372 $59.372 2401534 Ambulancia (Ida/Vuelta) $122.673 $122.673 $119.706 $119.706 $122.673 $122.673 2401513 Ambulancia Cerro Moreno Y/O Medicalizada $134.936 $134.936 $131.671 $131.671 $134.936 $134.936 2401514 Traslado Calama - Antofagasta $2.290.670 $2.290.670 $2.077.015 $2.077.015 $2.290.670 $2.290.670 2401515 Traslado Chuquicamata - Antofagasta $2.455.832 $2.455.832 $2.226.772 $2.226.772 $2.455.832 $2.455.832 2401516 Traslado San Pedro - Antofagasta $2.878.630 $2.878.630 $2.610.135 $2.610.135 $2.878.630 $2.878.630 2401517 Traslado Taltal - Antofagasta $2.698.715 $2.698.715 $2.447.002 $2.447.002 $2.698.715 $2.698.715 2401518 Traslado Iquique - Antofagasta $4.488.504 $4.488.504 $4.069.853 $4.069.853 $4.488.504 $4.488.504 2401062 Rescate profesionalizado y/o traslado paciente complejo $396.619 $396.619 $387.026 $387.026 $396.619 $396.619 2401063 Rescate medicalizado y/o traslado paciente crítico $705.103 $705.103 $688.048 $688.048 $705.103 $705.103 2401531 Rescate medicalizado y/o traslado paciente crítico $859.344 $859.344 $838.559 $838.559 $859.344 $859.344

CODIGO DESCRIPCION Habil 30 Lab Habil 301002 Acido fólico o folatos $5.940 $8.910 $18.991 $28.486 $27.601 $41.402 301005 Aglutininas anti Rho $5.310 $7.965 $12.577 $18.865 $18.290 $27.435 301007 Anticoagulantes circulantes o anticoagulante lúpico $5.310 $7.965 $42.902 $64.353 $62.337 $93.506 301008 Antitrombina III $5.310 $7.965 $54.205 $81.307 $78.783 $118.175 301010 Células del lupus, cada muestra $3.180 $4.770 $7.496 $11.244 $10.906 $16.359 301012 Coágulo, tiempo de retracción del $1.010 $1.515 $2.738 $4.107 $4.006 $6.009 301014 Coombs directo, test de $1.460 $2.190 $3.529 $5.293 $5.147 $7.721 301015 Coombs indirecto, prueba de $2.620 $3.930 $5.740 $8.610 $8.355 $12.533 301017 Deshidrogenasa glucosa-6-fosfato en eritrocitos $5.500 $8.250 $23.280 $34.920 $33.829 $50.744 301021 Fibrinógeno $2.620 $3.930 $13.558 $20.337 $19.714 $29.571 301024 Factor V $2.620 $3.930 $13.558 $20.337 $19.714 $29.571 301025 Factores VII, VIII, IX, X, XI, XII, XIII, c/u $5.500 $8.250 $17.849 $26.773 $25.943 $38.915 301026 Ferritina $6.740 $10.110 $15.916 $23.874 $23.125 $34.688 301027 Fibrinógeno, productos de degradación del $5.500 $8.250 $13.046 $19.569 $18.979 $28.469 301028 Fierro sérico $2.620 $3.930 $6.062 $9.093 $8.824 $13.236 301030 Fierro, cinética del (cada determinación) $6.640 $9.960 $13.046 $19.569 $18.979 $28.469 301034 Grupos sanguíneos AB0 y Rho (incluye estudio de factor Du en $2.960 $4.440 $5.110 $7.665 $7.433 $11.150 301035 Haptoglobina cuantitativa $4.930 $7.395 $10.996 $16.494 $15.991 $23.987 301036 Hematocrito (proc. aut.) $820 $1.230 $2.093 $3.139 $3.067 $4.601 301038 Hemoglobina en sangre total (proc. aut.) $820 $1.230 $1.931 $2.896 $2.832 $4.248 301040 Hemoglobina fetal cuantitativa en eritrocitos $5.500 $8.250 $12.577 $18.865 $18.290 $27.435 301041 Hemoglobina glicosilada $5.600 $8.400 $17.849 $26.773 $25.943 $38.915 301044 Hemoglobina, electroforesis de (incluye Hb. total) $5.940 $8.910 $26.415 $39.622 $38.398 $57.597 301045 Hemograma (incluye recuentos de leucocitos y eritrocitos, hem $3.680 $5.520 $9.562 $14.343 $13.908 $20.862 301059 Protombina, tiempo de o consumo de (incluye INR, Relación In $1.860 $2.790 $4.626 $6.939 $6.744 $10.116 301062 Recuento de basófilos (absoluto) $1.220 $1.830 $2.723 $4.084 $3.973 $5.960 301063 Recuento de eosinófilos (absoluto) $1.200 $1.800 $2.723 $4.084 $3.973 $5.960 301064 Recuento de eritrocitos, absoluto (proc. aut.) $820 $1.230 $1.931 $2.896 $2.832 $4.248 301065 Recuento de leucocitos, absoluto (proc. aut.) $820 $1.230 $1.931 $2.896 $2.832 $4.248 301066 Recuento de linfocitos (absoluto) $1.460 $2.190 $3.529 $5.293 $5.147 $7.721 301067 Recuento de plaquetas (absoluto) $1.460 $2.190 $3.529 $5.293 $5.147 $7.721 301068 Recuento de reticulocitos (absoluto o porcentual) $1.220 $1.830 $2.723 $4.084 $3.973 $5.960 301069 Recuento diferencial o fórmula leucocitaria (proc.aut.) $2.260 $3.390 $5.110 $7.665 $7.433 $11.150 301070 Resistencia globular osmótica $3.680 $5.520 $8.448 $12.672 $12.299 $18.449 301072 Sangría, tiempo de (Ivy) (no incluye dispositivo asociado ) $1.860 $2.790 $4.626 $6.939 $6.744 $10.116 301075 Subgrupo ABO y Rh fenotipo - genotipo Rh, c/u $3.230 $4.845 $6.546 $9.819 $9.513 $14.270 301082 Transferrina $6.530 $9.795 $15.916 $23.874 $23.125 $34.688

CODIGO DESCRIPCION Habil Habil 301083 Trombina, tiempo de $2.260 $3.390 $5.110 $7.665 $7.433 $11.150 301085 Tromboplastina, tiempo parcial de (TTPA,TTPK o similares) $2.910 $4.365 $7.496 $11.244 $10.906 $16.359 301086 Velocidad de eritosedimentación, (proc. aut.) $690 $1.035 $2.093 $3.139 $3.067 $4.601 301087 Vitamina B12, absorción de (Co 57 o similar) $14.300 $21.450 $35.068 $52.602 $50.979 $76.469 301089 Von Willebrand, Ag de (factor VIII Ag.) $10.690 $16.035 $50.632 $75.948 $73.588 $110.382 301091 Proteína C $35.890 $53.835 $64.558 $96.837 $93.803 $140.705 301092 Proteína S $39.660 $59.490 $60.529 $90.793 $87.968 $131.952 301501 Anfetaminas $23.831 $35.747 $16.398 $24.597 $23.831 $35.747 301502 Benzodiazepinas Orina $23.831 $35.747 $16.398 $24.597 $23.831 $35.747 301504 Bordetella Pertussis Por If $54.044 $81.066 $40.163 $60.244 $54.044 $81.066 301505 Bordetella Pertussis Igg $54.044 $81.066 $30.060 $45.090 $54.044 $81.066 301506 Bordetella Pertussis Igm $54.044 $81.066 $30.060 $45.090 $54.044 $81.066 301507 Canabinoides Determinacion De ( Thc) $23.831 $35.747 $16.398 $24.597 $23.831 $35.747 301509 Citraturia $35.863 $53.795 $24.672 $37.008 $35.863 $53.795 301510 Clonazepan ( Ravotril) $23.831 $35.747 $16.398 $24.597 $23.831 $35.747 301511 Cobre Orina (Cupruria) $34.517 $51.776 $23.735 $35.602 $34.517 $51.776 301512 Cocaina $23.831 $35.747 $16.398 $24.597 $23.831 $35.747 301513 Raspado de piel, examen microscópico de ("Acarotest"): de 6 a $9.857 $14.786 $6.618 $9.927 $9.857 $14.786 301514 Dehidroepiandrosterona sulfato (DHA, DHEA) $28.916 $43.374 $19.899 $29.848 $28.916 $43.374 301520 Antigeno Urinario Pneumococo $43.687 $65.531 $30.060 $45.090 $43.687 $65.531 301523 Estudio Von Willebrand $184.950 $277.425 $127.284 $190.926 $184.950 $277.425 301524 Factor V Leiden $95.182 $142.773 $65.494 $98.241 $95.182 $142.773 301525 Filtracion De Leucocitos $55.421 $83.132 $38.143 $57.214 $55.421 $83.132 301526 Resistencia A Proteina C Actv. $82.131 $123.197 $56.518 $84.777 $82.131 $123.197 301534 Htlv-1/2 $66.672 $100.008 $45.874 $68.811 $66.672 $100.008 301536 Igg4 Especifica C/U $148.992 $223.488 $31.642 $47.463 $148.992 $223.488 301541 Oxaluria $35.863 $53.795 $24.672 $37.008 $35.863 $53.795 301543 Peptido C $57.486 $86.229 $39.548 $59.322 $57.486 $86.229 301546 Phadiatop Adulto ( Inhalante) $125.552 $188.328 $86.402 $129.603 $125.552 $188.328 301547 Phadiatop Pediatrico ( Inhalante - Alimentos ) $125.552 $188.328 $86.402 $129.603 $125.552 $188.328 301548 Plomo ( Sangre ) $77.015 $115.523 $53.004 $79.506 $77.015 $115.523 301550 Pregnantriol (Orina) $32.515 $48.773 $24.159 $36.238 $32.515 $48.773 301553 Urobilinógeno (cuantitativo) $8.355 $12.533 $6.194 $9.291 $8.355 $12.533 301554 Screening Enf. Metabolica ( Incluye Aminoaciduria ). $124.473 $186.710 $85.655 $128.482 $124.473 $186.710 301556 Subclases Igg 1,2,3,4 $148.992 $223.488 $102.523 $153.784 $148.992 $223.488 301557 Test De Clonidina (5 Muestras) $161.949 $242.924 $111.355 $167.032 $161.949 $242.924 301560 Test Pack Clostridium Difficile A+B $34.814 $52.221 $23.954 $35.931 $34.814 $52.221 301569 Zinc ( Sangre ) $34.517 $51.776 $23.735 $35.602 $34.517 $51.776

CODIGO DESCRIPCION Habil Habil 301572 Orina, sedimento (proc. aut.) $4.193 $6.290 $2.869 $4.303 $4.193 $6.290 301579 Magnesio $12.299 $18.449 $8.448 $12.672 $12.299 $18.449 301580 Proteínas, electroforesis (incluye cód. 03-02-060) $19.636 $29.454 $13.499 $20.248 $19.636 $29.454 301281 TEST DE HOMA $28.321 $42.482 $28.321 $42.482 $28.321 $42.482 301585 Bartonella Henselae Serologia Igg $43.687 $65.531 $30.060 $45.090 $43.687 $65.531 301588 Bartonella Henselae Serologia Igm $43.687 $65.531 $30.060 $45.090 $43.687 $65.531 301589 Zinc Urinario $34.517 $51.776 $23.735 $35.602 $34.517 $51.776 302001 Acetona cualitativa $1.010 $1.515 $3.529 $5.293 $5.147 $7.721 302004 Acido láctico $4.720 $7.080 $8.434 $12.651 $12.283 $18.425 302005 Acido úrico, en sangre $1.940 $2.910 $4.320 $6.480 $6.289 $9.434 302008 Amilasa, en sangre $2.940 $4.410 $5.110 $7.665 $7.433 $11.150 302009 Aminoácidos, cualitativo en sangre $6.940 $10.410 $24.921 $37.381 $36.240 $54.360 302010 Amonio $2.620 $3.930 $5.740 $8.610 $8.355 $12.533 302011 Bicarbonato (proc.aut.) $820 $1.230 $2.093 $3.139 $3.067 $4.601 302012 Bilirrubina total (proc.aut.) $1.620 $2.430 $3.851 $5.776 $5.617 $8.426 302013 Bilirrubina total y conjugada $1.860 $2.790 $4.626 $6.939 $6.744 $10.116 302015 Calcio en sangre $1.660 $2.490 $3.690 $5.535 $5.382 $8.073 302016 Calcio iónico, incluye proteínas totales $3.230 $4.845 $9.253 $13.879 $13.457 $20.186 302017 Caroteno $2.620 $3.930 $5.740 $8.610 $8.355 $12.533 302018 Caroteno, prueba de sobrecarga de, además 2 códigos 03-07-0 $5.920 $8.880 $13.529 $20.293 $19.684 $29.526 302019 Ceruloplasmina $4.060 $6.090 $21.874 $32.811 $31.811 $47.717 302020 Cobre $1.900 $2.850 $23.735 $35.602 $34.517 $51.776 302021 Colinesterasa en plasma o sangre total $3.680 $5.520 $8.448 $12.672 $12.299 $18.449 302023 Creatinina en sangre $1.620 $2.430 $3.690 $5.535 $5.382 $8.073 302024 Creatinina, depuración de (Clearence) (proc.aut.) $3.630 $5.445 $9.076 $13.614 $13.205 $19.808 302025 Creatinquinasa CK - MB miocárdica $5.920 $8.880 $9.385 $14.077 $13.690 $20.535 302026 Creatinquinasa CK - total $4.500 $6.750 $10.337 $15.505 $15.037 $22.556 302027 Troponina $11.860 $17.790 $39.913 $59.869 $61.133 $91.700 302029 Deshidrogenasa hidroxibutírica (HBDH) $2.620 $3.930 $5.740 $8.610 $8.355 $12.533 302030 Deshidrogenasa láctica total (LDH) $2.750 $4.125 $5.740 $8.610 $8.355 $12.533 302032 Electrolitos plasmáticos (sodio, potasio, cloro) c/u $1.490 $2.235 $5.608 $8.412 $8.167 $12.251 302033 Enzima convertidora de angiotensina I $7.360 $11.040 $22.284 $33.426 $32.406 $48.609 302034 Perfil Lipídico (incluye: colesterol total, HDL, LDL, VLDL y triglic $7.710 $11.565 $20.849 $31.273 $30.323 $45.485 302035 Fármacos y/o drogas; niveles plasmáticos de (alcohol, anorexíg $6.930 $10.395 $16.398 $24.597 $23.831 $35.747 302036 Fenilalanina $2.620 $3.930 $9.123 $13.684 $13.269 $19.904 302037 Fosfatasas ácidas totales $2.130 $3.195 $5.110 $7.665 $7.433 $11.150 302038 Fosfatasas ácidas totales y fracción prostática. $3.680 $5.520 $8.448 $12.672 $12.299 $18.449 302039 Fosfatasas alcalinas con separación de isoenzimas hepáticas, in $7.100 $10.650 $56.957 $85.435 $82.773 $124.160

CODIGO DESCRIPCION Habil Habil 302040 Fosfatasas alcalinas totales $1.660 $2.490 $3.529 $5.293 $5.147 $7.721 302041 Fosfolípidos $1.860 $2.790 $4.320 $6.480 $6.289 $9.434 302042 Fósforo (fosfatos) en sangre $2.180 $3.270 $4.320 $6.480 $6.289 $9.434 302045 Gamma glutamiltranspeptidasa (GGT) $2.860 $4.290 $6.706 $10.059 $9.762 $14.643 302046 Gases y equilibrio ácido base en sangre (incluye: ph, O2, CO2, $4.530 $6.795 $8.609 $12.913 $12.518 $18.777 302047 Glucosa en sangre $1.580 $2.370 $2.401 $3.601 $3.536 $5.304 302048 Glucosa, Prueba de Tolerancia a la Glucosa Oral (PTGO), (dos d $7.390 $11.085 $9.984 $14.976 $14.912 $22.368 302050 Adenosindeaminasa en sangre u otro fluído biológico. $5.500 $8.250 $9.942 $14.913 $14.457 $21.686 302053 Lipasa $2.910 $4.365 $7.335 $11.002 $10.687 $16.031 302054 Lipoproteínas, electroforesis de (incluye lípidos totales) $8.180 $12.270 $26.415 $39.622 $38.398 $57.597 302055 Litio $3.680 $5.520 $12.754 $19.131 $18.558 $27.837 302056 Magnesio $3.680 $5.520 $8.448 $12.672 $12.299 $18.449 302057 Nitrógeno ureico y/o urea, en sangre $1.600 $2.400 $2.401 $3.601 $3.536 $5.304 302059 Proteínas fraccionadas albúmina/globulina (incluye código 03- $2.820 $4.230 $6.706 $10.059 $9.762 $14.643 302060 Proteínas totales o albúminas, c/u, en sangre $1.810 $2.715 $4.320 $6.480 $6.289 $9.434 302061 Proteínas, electroforesis (incluye cód. 03-02-060) $7.780 $11.670 $13.499 $20.248 $19.636 $29.454 302063 Transaminasas, oxalacética (GOT/AST), Pirúvica (GPT/ALT), c/u $2.370 $3.555 $6.237 $9.355 $9.091 $13.637 302064 Triglicéridos (proc.aut.) $2.190 $3.285 $4.626 $6.939 $6.744 $10.116 302066 Xilosa, prueba de absorción (no incluye la xilosa que se admini $3.870 $5.805 $5.725 $8.587 $8.433 $12.650 302067 Colesterol total (proc.aut.) $1.700 $2.550 $5.446 $8.169 $7.947 $11.921 302068 Colesterol HDL (proc. aut.) $2.480 $3.720 $5.417 $8.125 $7.884 $11.826 302069 Lípidos totales (proc.aut.) $2.180 $3.270 $6.843 $10.264 $30.323 $45.485 302070 Apolipoproteínas (AI.B u otras) $8.020 $12.030 $22.284 $33.426 $32.406 $48.609 302075 Perfil Bioquímico (determinación automatizada de 12 parámet $10.400 $15.600 $25.712 $38.568 $37.365 $56.048 302076 Perfil Hepático (incluye tiempo de protrombina, bilirrubina tot $12.910 $19.365 $32.768 $49.152 $47.615 $71.423 302501 Catecolaminas $39.118 $58.677 $26.912 $40.368 $39.118 $58.677 302502 Vancomicina $23.831 $35.747 $16.398 $24.597 $23.831 $35.747 302504 Dimero D $41.403 $62.105 $28.479 $42.718 $41.403 $62.105 302505 Pro-Bnp $89.673 $134.510 $61.702 $92.553 $89.673 $134.510 302508 25 - Hidroxi Vitamina D $111.830 $167.745 $76.959 $115.438 $111.830 $167.745 302509 Arsenico $105.993 $158.990 $72.933 $109.399 $105.993 $158.990 302510 Pre-Albumina $23.689 $35.534 $16.296 $24.444 $23.689 $35.534 302511 Acido Acetilsalicilico $23.831 $35.747 $16.398 $24.597 $23.831 $35.747 302512 Ciclosporina $82.085 $123.128 $56.488 $84.732 $82.085 $123.128 302513 Homocisteina $85.215 $127.823 $58.627 $87.940 $85.215 $127.823 302514 Fructosamina $26.225 $39.338 $18.038 $27.057 $26.225 $39.338 302515 Sulfaniureas Nivel Plasmatico $197.998 $296.997 $136.259 $204.388 $197.998 $296.997 302516 Tacrolimus, Nivel Plasmatico $137.929 $206.894 $94.925 $142.387 $137.929 $206.894

CODIGO DESCRIPCION Habil Habil 302519 Lamotrigina $23.831 $35.747 $16.398 $24.597 $23.831 $35.747 302520 Catecolaminas $39.118 $58.677 $26.912 $40.368 $39.118 $58.677 302521 Haptoglobina cuantitativa $15.991 $23.987 $10.996 $16.494 $15.991 $23.987 302524 Paracetamol Niveles Plasmaticos $23.831 $35.747 $16.398 $24.597 $23.831 $35.747 302525 Peptido Natriuretico Cerebral (Bnp) $57.486 $86.229 $39.548 $59.322 $57.486 $86.229 302526 Screening Metabolico (Tandem) $124.473 $186.710 $85.655 $128.482 $124.473 $186.710 302527 Screening Metabolico Ampliado $124.473 $186.710 $85.655 $128.482 $124.473 $186.710 303001 Adenocorticotrofina (ACTH) $10.210 $15.315 $26.899 $40.348 $39.086 $58.629 303002 Aldosterona $8.750 $13.125 $22.271 $33.406 $32.390 $48.585 303003 Androstenediona $6.640 $9.960 $22.314 $33.471 $32.452 $48.678 303005 Catecolaminas $8.750 $13.125 $26.912 $40.368 $39.118 $58.677 303006 Cortisol $6.640 $9.960 $22.314 $33.471 $32.452 $48.678 303007 Crecimiento, hormona de (HGH) (somatotrofina) $8.750 $13.125 $22.271 $33.406 $32.390 $48.585 303008 Dehidroepiandrosterona sulfato (DHA, DHEA) $8.620 $12.930 $19.899 $29.848 $28.916 $43.374 303009 Eritropoyetina $6.270 $9.405 $13.046 $19.569 $18.979 $28.469 303010 Estriol en sangre $6.530 $9.795 $35.859 $53.788 $52.104 $78.156 303011 Estrona $6.640 $9.960 $22.314 $33.471 $32.452 $48.678 303012 Gastrina $8.750 $13.125 $26.912 $40.368 $39.118 $58.677 303014 Gonadotrofina coriónica, sub-unidad beta (incluye titulación si $6.430 $9.645 $22.314 $33.471 $32.452 $48.678 303015 Hormona folículo estimulante (FSH) $6.430 $9.645 $22.314 $33.471 $32.452 $48.678 303016 Hormona luteinizante (LH) $6.430 $9.645 $18.799 $28.198 $27.335 $41.003 303017 Insulina $6.320 $9.480 $17.043 $25.564 $24.784 $37.176 303018 Parathormona, hormona Paratiroídea o PTH. $9.950 $14.925 $31.349 $47.023 $45.563 $68.345 303019 Progesterona $6.430 $9.645 $22.314 $33.471 $32.452 $48.678 303020 Prolactina (PRL) $6.430 $9.645 $22.314 $33.471 $32.452 $48.678 303021 Renina $8.750 $13.125 $22.271 $33.406 $32.390 $48.585 303022 Testosterona en sangre $6.640 $9.960 $17.511 $26.266 $25.457 $38.186 303023 Testosterona libre en sangre $7.980 $11.970 $20.382 $30.573 $29.635 $44.453 303024 Tiroestimulante (TSH), hormona (Adulto, niño o R.N.) $5.600 $8.400 $22.314 $33.471 $32.452 $48.678 303025 Tiroglobulina $8.750 $13.125 $11.113 $16.669 $16.695 $25.043 303026 Tiroxina libre (T4L) $6.430 $9.645 $22.314 $33.471 $32.452 $48.678 303027 Tiroxina o tetrayodotironina (T4) $5.600 $8.400 $17.849 $26.773 $25.943 $38.915 303028 Triyodotironina (T3) $5.600 $8.400 $17.849 $26.773 $25.943 $38.915 303029 17 - Hidroxiprogesterona $8.750 $13.125 $16.385 $24.577 $23.815 $35.723 303030 Estradiol (17-Beta) $6.320 $9.480 $22.314 $33.471 $32.452 $48.678 303031 Insulina, curva de (mínimo cuatro determinaciones e incluye to $17.060 $25.590 $47.732 $71.598 $69.364 $104.046 303032 Ac. vainillilmandélico, cuantitativo $6.000 $9.000 $33.003 $49.504 $47.974 $71.961 303034 Catecolaminas $8.750 $13.125 $26.912 $40.368 $39.118 $58.677

CODIGO DESCRIPCION Habil Habil 303035 Cortisol libre urinario $7.200 $10.800 $22.284 $33.426 $32.406 $48.609 303036 Estriol $6.640 $9.960 $16.398 $24.597 $23.831 $35.747 303039 Gonadotrofina coriónica, sub-unidada Beta; titulación por (Elis $6.640 $9.960 $16.398 $24.597 $23.831 $35.747 303043 17 - Cetoesteroides $6.530 $9.795 $12.402 $18.603 $18.025 $27.038 303044 17 - Hidroxicorticoesteroides $6.640 $9.960 $12.402 $18.603 $18.025 $27.038 303046 SHBG (Sex-Hormone Binding Globulin) $15.060 $22.590 $21.890 $32.835 $32.328 $48.492 303047 IGF1 o Somatomedina - C (Insuline Like Growth Factor) $15.300 $22.950 $21.890 $32.835 $32.328 $48.492 303048 IGFBP3, IGFBP1 (Insulin Like Growth Factor Binding Proteins) c $15.300 $22.950 $21.890 $32.835 $32.328 $48.492 303501 Trab $66.672 $100.008 $45.874 $68.811 $66.672 $100.008 303503 Tiroxina libre (T4L) $32.452 $48.678 $22.314 $33.471 $32.452 $48.678 303582 Peptido Ciclico Citrulinado $57.486 $86.229 $39.548 $59.322 $57.486 $86.229 304004 Cromatina sexual X e Y, corpúsculo de Barr y corpúsculo fluore $9.200 $13.800 $16.852 $25.278 $24.519 $36.779 304008 Cariograma En Sangre $689.634 $1.034.451 $474.636 $711.954 $689.634 $1.034.451 304009 Cariograma Vellosidades Coriales $649.140 $973.710 $446.773 $670.159 $649.140 $973.710 304501 Cariograma Reg. Subtelomericas $689.634 $1.034.451 $474.636 $711.954 $689.634 $1.034.451 304502 Estudio De Paternidad $689.634 $1.034.451 $474.636 $711.954 $689.634 $1.034.451 304503 Estudio Inmunologico Para Diabetis $137.477 $206.216 $94.603 $141.904 $137.477 $206.216 305001 Alfa -1- antitripsina cuantitativa $6.640 $9.960 $19.912 $29.868 $28.930 $43.395 305003 Alfa fetoproteínas $6.430 $9.645 $19.912 $29.868 $28.930 $43.395 305004 Tamizaje de Anticuerpos anti antígenos nucleares extractables $12.800 $19.200 $19.855 $29.782 $29.024 $43.536 305005 Anticuerpos antinucleares (ANA), antimitocondriales, anti DNA $8.980 $13.470 $22.431 $33.646 $32.608 $48.912 305007 Anticuerpos específicos y otros autoanticuerpos (anticuerpos a $7.200 $10.800 $17.673 $26.509 $54.200 $81.300 305008 Antiestreptolisina O, por técnica de látex $5.790 $8.685 $10.659 $15.988 $15.506 $23.259 305009 Antígeno carcinoembrionario (CEA) $8.750 $13.125 $26.912 $40.368 $39.118 $58.677 305010 Beta-2-microglobulina $8.750 $13.125 $17.702 $26.553 $23.815 $35.723 305012 Complemento C1Q, C2, C3, C4, etc., c/u $5.790 $8.685 $17.995 $26.992 $26.162 $39.243 305013 Complemento hemolítico (CH 50) $7.200 $10.800 $13.353 $20.029 $19.433 $29.150 305014 Crioglobulinas, precipitación en frío (cualitativa) o cuantitativa $1.390 $2.085 $3.690 $5.535 $5.382 $8.073 305020 Factor reumatoídeo por técnica de Scat, Waaler Rose, nefelom $5.700 $8.550 $14.979 $22.468 $21.780 $32.670 305021 Inhibidor de C1Q, C2 y C3, c/u $5.790 $8.685 $15.813 $23.719 $36.801 $55.202 305022 Inmunoelectroforesis de cadenas livianas Kappa o Lambda libr $6.640 $9.960 $28.376 $42.564 $41.230 $61.845 305023 Inmunoelectroforesis de inmunoglobulinas cadenas pesadas (I $5.790 $8.685 $28.376 $42.564 $41.230 $61.845 305024 Inmunoelectroforesis de inmunoglobulinas IgD e IgE c/u $6.420 $9.630 $28.376 $42.564 $41.230 $61.845 305026 Inmunoglobulina IgA secretora $5.600 $8.400 $18.799 $28.198 $27.335 $41.003 305027 Inmunoglobulinas IgA, IgG, IgM, c/u $5.790 $8.685 $18.317 $27.475 $26.647 $39.971 305028 Inmunoglobulinas IgE, IgD total, c/u $6.640 $9.960 $28.376 $42.564 $41.230 $61.845 305029 Inmunoglobulinas IgE, IgG específicas, c/u $6.530 $9.795 $16.398 $24.597 $23.831 $35.747 305031 Proteína C reactiva por técnicas nefelométricas y/o turbidimét $7.490 $11.235 $16.076 $24.114 $23.376 $35.064

CODIGO DESCRIPCION Habil Habil 305032 Proteínas Bence Jones por electroforesis (incluye proteinuria) $7.540 $11.310 $13.821 $20.731 $20.106 $30.159 305035 Crioaglutininas $2.910 $4.365 $6.224 $9.336 $9.075 $13.613 305037 Digestión fagocítica nitroblue-tetrazolium cualitativo y cuantita $7.360 $11.040 $11.933 $17.899 $17.352 $26.028 305038 Fagocitosis: ingestión y digestión (killing) de levaduras por poli $15.170 $22.755 $21.890 $32.835 $32.294 $48.441 305043 Linfocitos B (inmunofluorescencia) $6.720 $10.080 $23.573 $35.359 $34.267 $51.401 305045 Linfocitos T "helper" (OKT4) o supresores (OKT8) con antisuero $7.360 $11.040 $18.302 $27.453 $26.599 $39.899 305046 Linfocitos T totales ( OKT3 y/o OKT11) con antisuero monoclon $7.360 $11.040 $18.302 $27.453 $26.599 $39.899 305060 Tipificación HLA B-27. $20.420 $30.630 $35.068 $52.602 $50.979 $76.469 305070 Antígeno prostático específico $11.260 $16.890 $28.801 $43.201 $41.856 $62.784 305081 Anticuerpo antiendomisio (EMA, antimembrana basal glomeru $13.470 $20.205 $22.431 $33.646 $32.608 $48.912 305082 Anticuerpos anticitoplasma de neutrófilos (ANCA), C-ANCA y P $20.050 $30.075 $29.972 $44.958 $44.108 $66.162 305084 Anticuerpos anticardiolipinas por Elisa (isotipos G-M-A), c/u. $15.310 $22.965 $47.249 $70.873 $68.660 $102.990 305086 Anticuerpos antigliadina (enfermedad celiaca), por Elisa (isotip $13.470 $20.205 $22.431 $33.646 $32.608 $48.912 305170 Antígeno Ca 125, Ca 15-3 y Ca 19-9, c/u $11.420 $17.130 $28.801 $43.201 $41.856 $62.784 305181 Estudio de Anticuerpo Antitransglutaminsa (TTG) $13.660 $20.490 $31.642 $47.463 $46.002 $69.003 305182 Reacción de Polimerasa en cadena (P.C.R.), virus Influenza, viru $23.160 $34.740 $73.210 $109.815 $106.369 $159.554 305501 Ac. Anti Lkm-1 $68.268 $102.402 $46.986 $70.479 $68.268 $102.402 305502 Ac. Anti Gad $34.517 $51.776 $23.735 $35.602 $34.517 $51.776 305503 Ac. Anti Insulina $34.517 $51.776 $23.735 $35.602 $34.517 $51.776 305504 Ac. Anti-Islotes $95.744 $143.616 $71.160 $106.740 $95.744 $143.616 305505 Ac. Anti-Plaquetarios $56.330 $84.495 $38.758 $58.137 $56.330 $84.495 305506 Anticuerpos Antineumococo $162.996 $244.494 $112.173 $168.259 $162.996 $244.494 305509 Mutac. G 20210 A Del Gen De La Protrombina Stg $95.182 $142.773 $65.494 $98.241 $95.182 $142.773 305511 Ac. Peptidos Deaminados Gliadina Iga $32.608 $48.912 $22.431 $33.646 $32.608 $48.912 305512 Ac. Peptidos Deaminados Gliadina Igg $32.608 $48.912 $22.431 $33.646 $32.608 $48.912 305513 Traslocacion 9;22 Por Pcr $160.931 $241.397 $110.752 $166.128 $160.931 $241.397 305516 Ac Anti Proteína P Ribosomal $32.608 $48.912 $22.431 $33.646 $32.608 $48.912 305522 TIPIFICACION HLA A Y B (CLASE 1) $221.683 $332.525 $221.683 $332.525 $221.683 $332.525 306001 Baciloscopia Ziehl-Neelsen por concentración de líquidos (orin $3.120 $4.680 $6.224 $9.336 $9.075 $13.613 306002 Baciloscopia Ziehl-Neelsen, c/u $2.130 $3.195 $5.110 $7.665 $7.433 $11.150 306004 Examen directo al fresco, c/s tinción (incluye trichomonas) $1.860 $2.790 $4.626 $6.939 $6.744 $10.116 306005 Tinción de Gram $820 $1.230 $3.529 $5.293 $5.147 $7.721 306006 Ultramicroscopía (incluye toma de muestras) $5.500 $8.250 $12.577 $18.865 $18.290 $27.435 306007 Coprocultivo, c/u $5.120 $7.680 $9.401 $14.101 $13.690 $20.535 306008 Cultivo corriente (excepto coprocultivo, hemocultivo y urocult $4.240 $6.360 $7.160 $10.740 $10.420 $15.630 306009 Hemocultivo aerobio, c/u $5.220 $7.830 $10.030 $15.045 $14.583 $21.875 306010 Hemocultivo anaerobio, c/u $8.590 $12.885 $16.474 $24.711 $22.187 $33.281 306011 Urocultivo, recuento de colonias y antibiograma (cualquier téc $4.480 $6.720 $10.030 $15.045 $14.583 $21.875

CODIGO DESCRIPCION Habil Habil 306012 Cultivo para Anaerobios (incluye Cód. 03-06-008) $8.180 $12.270 $13.499 $20.248 $19.636 $29.454 306014 Cultivo para Campylobacter, Yersinia, Vibrio, c/u $5.500 $8.250 $17.218 $25.827 $25.034 $37.551 306016 Neisseria gonorrhoeae (gonococo) $3.660 $5.490 $8.302 $12.453 $12.080 $18.120 306017 Cultivo para Levaduras $3.310 $4.965 $6.224 $9.336 $9.075 $13.613 306018 Cultivo para bacilo de Koch, (incluye otras micobacterias) $5.340 $8.010 $12.577 $18.865 $18.290 $27.435 306020 Cultivo para Listeria $5.500 $8.250 $10.835 $16.252 $14.583 $21.875 306021 Neisseria meningitidis (meningococo) $3.660 $5.490 $7.483 $11.224 $10.890 $16.335 306022 Cultivo y Tipificación de micobacterias $5.500 $8.250 $13.588 $20.382 $18.290 $27.435 306023 Cultivo de Mycoplasma y Ureaplasma, c/u $7.570 $11.355 $12.577 $18.865 $18.290 $27.435 306026 Antibiograma Corriente (mínimo 10 fármacos) (en caso de uro $3.420 $5.130 $6.224 $9.336 $9.075 $13.613 306027 Antibiograma de estudio de sensibilidad por dilución (CIM) (m $9.440 $14.160 $12.635 $18.952 $18.838 $28.257 306032 Aspergilosis, candidiasis, histoplasmosis u otros hongos por inm $6.060 $9.090 $13.588 $20.382 $18.290 $27.435 306034 Clamidias por inmunofluorescencia, peroxidasa, Elisa o similar $6.700 $10.050 $12.562 $18.843 $18.275 $27.413 306036 Mononucleosis, reacción de Paul Bunnell, Anticuerpos Heteróf $2.940 $4.410 $6.370 $9.555 $9.279 $13.919 306037 Mycoplasma IgG, IgM, c/u. $5.920 $8.880 $16.296 $24.444 $23.689 $35.534 306038 R.P.R. $3.220 $4.830 $6.852 $10.278 $9.967 $14.951 306039 Tíficas, reacciones de aglutinación (Eberth H y O, paratyphi A y $4.510 $6.765 $10.030 $15.045 $14.583 $21.875 306041 Treponema pallidum FTA - ABS, MHA-TP c/u $6.060 $9.090 $12.577 $18.865 $18.290 $27.435 306042 V.D.R.L. $3.760 $5.640 $6.852 $10.278 $9.967 $14.951 306043 Artrópodos macroscópicos y microscópicos (imagos y/o pupas $3.660 $5.490 $10.060 $15.090 $14.630 $21.945 306045 Coproparasitario seriado con técnica para Cryptosporidium sp $10.830 $16.245 $26.575 $39.862 $38.617 $57.926 306046 Coproparasitario seriado para Fasciola hepática (incluye diagnó $21.780 $32.670 $34.438 $51.657 $50.322 $75.483 306047 Coproparasitario seriado para Isospora y Sarcocystis (incluye d $5.920 $8.880 $10.014 $15.021 $14.568 $21.852 306048 Coproparasitológico seriado simple (incluye diagnóstico de gus $3.790 $5.685 $7.483 $11.224 $10.890 $16.335 306049 Diagnóstico de parásitos en jugo duodenal y/o bilis, examen m $3.620 $5.430 $7.804 $11.706 $11.361 $17.042 306051 Graham, examen de (incluye diagnóstico de gusanos macroscó $2.590 $3.885 $6.062 $9.093 $8.824 $13.236 306052 Gusanos macroscópicos, diagnóstico de (proc. aut.) $2.130 $3.195 $5.270 $7.905 $7.666 $11.499 306053 Hemoparásitos, diagnóstico microscópico de (mínimo 10 frotis $10.980 $16.470 $16.984 $25.476 $24.848 $37.272 306056 Raspado de piel, examen microscópico de ("Acarotest"): de 6 a $4.930 $7.395 $6.618 $9.927 $9.857 $14.786 306057 Tenias post trat., diagnóstico y búsqueda de escólex de $3.620 $5.430 $9.971 $14.956 $13.440 $20.160 306059 Coproparasitológico seriado simple (incluye diagnóstico de gus $4.900 $7.350 $13.851 $20.776 $20.153 $30.230 306061 Elisa indirecta (Chagas, hidatidosis, toxocariasis y otras), c/u $6.720 $10.080 $16.398 $24.597 $23.831 $35.747 306069 Anticuerpos virales, determ. de (adenovirus, citomegalovirus, $6.990 $10.485 $16.398 $24.597 $23.831 $35.747 306070 Antígenos virales determ. de (adenovirus, citomegalovirus, her $6.320 $9.480 $37.147 $55.720 $53.982 $80.973 306073 Virus hepatitis A, Anticore $6.720 $10.080 $16.398 $24.597 $23.831 $35.747 306074 Virus hepatitis A, anticuerpos IgM del $9.460 $14.190 $21.802 $32.703 $31.701 $47.552 306076 Virus hepatitis B, anticore total del (anti HBc total) $8.740 $13.110 $17.335 $26.002 $25.222 $37.833 306077 Virus hepatitis B, antígeno de superficie o antígeno australiano $6.540 $9.810 $16.398 $24.597 $23.831 $35.747

CODIGO DESCRIPCION Habil Habil 306078 Virus hepatitis B, antígeno E del (HBEAg) $8.180 $12.270 $15.741 $23.611 $22.892 $34.338 306080 Virus hepatitis B, anticore IgM del (anti HBc IgM) $9.070 $13.605 $23.413 $35.119 $34.016 $51.024 306081 Virus hepatitis C, anticuerpos de (anti HCV) $10.050 $15.075 $16.852 $25.278 $24.519 $36.779 306090 Test rápido de detección de streptococcus. $6.820 $10.230 $21.816 $32.724 $31.716 $47.574 306117 Cultivo para hongos filamentosos $3.780 $5.670 $5.725 $8.587 $8.386 $12.579 306169 Anticuerpos virales, determ. de H.I.V. $6.670 $10.005 $16.398 $24.597 $23.831 $35.747 306170 Antígenos virales determ. de rotavirus, por cualquier técnica $6.320 $9.480 $14.481 $21.721 $21.045 $31.568 306171 Virus hepatitis A, Anticore $23.831 $35.747 $16.398 $24.597 $23.831 $35.747 306177 Virus hepatitis B, anticuerpo del antígeno E del $25.222 $37.833 $17.335 $26.002 $25.222 $37.833 306270 Antígenos virales determ. de virus sincicial, por cualquier técni $6.900 $10.350 $37.132 $55.698 $53.966 $80.949 306503 Legionella Antigeno Urinario $259.117 $388.676 $218.225 $327.337 $259.117 $388.676 306506 Hpv Por Pcr (Pack) $140.246 $210.369 $96.506 $144.759 $140.246 $210.369 306507 Parvovirus B19 Igg $43.687 $65.531 $30.060 $45.090 $43.687 $65.531 306508 Parvovirus B19 Igm $43.687 $65.531 $30.060 $45.090 $43.687 $65.531 306510 Hepatitis B Carga Viral $516.530 $774.795 $355.494 $533.241 $516.530 $774.795 306511 Parotiditis Igg $43.687 $65.531 $30.060 $45.090 $43.687 $65.531 306512 Parotiditis Igm $43.687 $65.531 $30.060 $45.090 $43.687 $65.531 306513 Examen directo al fresco, c/s tinción (incluye trichomonas) $6.744 $10.116 $4.626 $6.939 $6.744 $10.116 306514 Hepatitis E Igm $174.326 $261.489 $119.962 $179.943 $174.326 $261.489 306516 Citomegalovirus Antigenemia $213.145 $319.718 $146.699 $220.048 $213.145 $319.718 306518 Espectrometria De Masas $59.771 $89.657 $41.130 $61.695 $59.771 $89.657 306519 Hiv Carga Viral $413.758 $620.637 $284.774 $427.161 $413.758 $620.637 306520 Latex Lcr $18.369 $27.554 $13.632 $20.448 $18.369 $27.554 306521 Leptospira Igg $122.204 $183.306 $84.089 $126.133 $122.204 $183.306 306522 Leptospira Igm $122.204 $183.306 $84.089 $126.133 $122.204 $183.306 306523 Panel Viral En Lcr Por Pcr (Mediflex) $390.804 $586.206 $268.960 $403.440 $390.804 $586.206 306524 Parvovirus B19 Por Pcr $107.591 $161.387 $74.045 $111.067 $107.591 $161.387 306527 Aspergillus Anticuerpos Totales $77.735 $116.603 $53.488 $80.232 $77.735 $116.603 306528 Bordetella Pertussis Por Pcr $106.369 $159.554 $73.210 $109.815 $106.369 $159.554 306529 Brucella Igg $43.687 $65.531 $30.060 $45.090 $43.687 $65.531 306530 Brucella Igm $43.687 $65.531 $30.060 $45.090 $43.687 $65.531 306531 Enterovirus Pcr $149.430 $224.145 $102.832 $154.248 $149.430 $224.145 306534 Hepatitis E Igg $73.290 $109.935 $50.426 $75.639 $73.290 $109.935 306536 Htlv Por Pcr $106.369 $159.554 $73.210 $109.815 $106.369 $159.554 306537 Mycoplasma Pneumoniae Por Pcr $106.369 $159.554 $73.210 $109.815 $106.369 $159.554 306538 Pneumocystis Jiroveci Pcr $106.369 $159.554 $73.210 $109.815 $106.369 $159.554 306539 Toxoplasma Por Pcr $106.369 $159.554 $73.210 $109.815 $106.369 $159.554 306566 Serologia Amebiasis $43.687 $65.531 $30.060 $45.090 $43.687 $65.531

CODIGO DESCRIPCION Habil Habil 306770 Influenza Test Pack $53.982 $80.973 $37.147 $55.720 $53.982 $80.973 307009 Arterial en adultos $1.460 $2.190 $3.382 $5.073 $4.945 $7.418 307010 Arterial en niños y lactantes $2.130 $3.195 $4.157 $6.235 $6.071 $9.107 307011 Venosa en adultos $1.020 $1.530 $2.093 $3.139 $3.067 $4.601 307012 Venosa en niños y lactantes $1.010 $1.515 $3.382 $5.073 $4.945 $7.418 307013 Con técnica aséptica para hemocultivo, c/u $1.520 $2.280 $3.382 $5.073 $4.945 $7.418 307014 Capilar ( adultos, niños y lactantes ) $820 $1.230 $2.093 $3.139 $3.067 $4.601 307502 Swim Up (Capacitacion Espermatica) $18.600 $27.900 $9.605 $14.407 $18.600 $27.900 307503 Test Post Coital $8.637 $12.956 $5.930 $8.895 $8.637 $12.956 308001 Azúcares reductores (Benedict-Fehling o similar) $1.440 $2.160 $3.382 $5.073 $4.945 $7.418 308003 Grasas neutras (Sudán III) $820 $1.230 $3.382 $5.073 $4.945 $7.418 308004 Hemorragias ocultas, (bencidina, guayaco o test de Weber y si $1.460 $2.190 $3.382 $5.073 $4.945 $7.418 308005 Leucocitos fecales $1.460 $2.190 $3.382 $5.073 $4.945 $7.418 308006 ph $820 $1.230 $1.931 $2.896 $2.832 $4.248 308009 Células neoplásicas en fluídos biológicos $5.180 $7.770 $11.479 $17.218 $16.695 $25.043 308010 Citológico c/s tinción (incluye examen al fresco, recuento celul $3.680 $5.520 $8.302 $12.453 $12.080 $18.120 308011 Directo al fresco c/s tinción, (incluye trichomonas) $1.860 $2.790 $4.626 $6.939 $6.744 $10.116 308012 Electrólitos (sodio, potasio, cloro), c/u $1.860 $2.790 $13.896 $20.844 $20.201 $30.302 308013 Eosinófilos, recuento de $1.010 $1.515 $3.382 $5.073 $4.945 $7.418 308014 Físico-químico (incluye aspecto, color, ph, glucosa, proteína, P $2.910 $4.365 $6.546 $9.819 $9.513 $14.270 308015 Glucosa en exudados, secreciones y otros líquidos $820 $1.230 $2.093 $3.139 $3.067 $4.601 308017 ph, (proc. aut.) $820 $1.230 $1.931 $2.896 $2.832 $4.248 308018 Proteínas totales o albúmina (proc. aut.) c/u $1.860 $2.790 $4.157 $6.235 $6.071 $9.107 308020 Bandas oligoclonales (incluye electroforesis de L.C.R., suero e i $26.540 $39.810 $55.375 $83.062 $80.473 $120.710 308022 Indice IgG/albúmina (incluye determ. de IgG y albúmina en L.C $14.720 $22.080 $28.317 $42.475 $38.132 $57.198 308023 Estudio de cristales (con luz polarizada) $1.860 $2.790 $4.157 $6.235 $6.071 $9.107 308029 Espermiograma (físico y microscópico, con o sin observación h $4.960 $7.440 $17.849 $26.773 $25.943 $38.915 308033 Células anaranjadas (proc. aut.) $820 $1.230 $1.931 $2.896 $2.832 $4.248 308039 Madurez fetal completa (físico; células anaranjadas, bilirrubina $7.380 $11.070 $26.283 $39.424 $38.209 $57.314 308040 Test de Clements (proc. aut.) $1.460 $2.190 $3.382 $5.073 $4.945 $7.418 308043 Moco-semen, prueba de compatibilidad $2.860 $4.290 $6.546 $9.819 $9.513 $14.270 308044 Flujo vaginal o secreción uretral, estudio de (incluye toma de m $9.920 $14.880 $22.754 $34.131 $33.076 $49.614 308501 Test Inmunologico Deteccion Hemoglobina Humana $4.945 $7.418 $3.382 $5.073 $4.945 $7.418 308502 Esteatocrito $22.984 $34.476 $15.813 $23.719 $22.984 $34.476 308503 Helicobacter Pylori En Deposicion $11.391 $17.087 $8.880 $13.320 $11.391 $17.087 309002 Acido delta aminolevulínico $5.940 $8.910 $16.414 $24.621 $23.878 $35.817 309004 Acido úrico o urea en orina (cuantitativo) $2.620 $3.930 $4.626 $6.939 $6.744 $10.116 309005 Acido 5 hidroxiindolacético cuantitativo $6.160 $9.240 $32.037 $48.055 $46.566 $69.849

CODIGO DESCRIPCION Habil Habil 309006 Amilasa cuantitativa en orina $3.230 $4.845 $5.270 $7.905 $7.666 $11.499 309007 Aminoácidos en orina (cualitativo)(excepto fenilalanina, PKU) $5.940 $8.910 $16.414 $24.621 $23.878 $35.817 309008 Calcio cuantitativo en orina $2.420 $3.630 $5.740 $8.610 $8.355 $12.533 309009 Cálculo urinario (examen físico y químico) $5.120 $7.680 $12.415 $18.622 $18.041 $27.062 309010 Creatinina cuantitativa en orina $1.860 $2.790 $4.157 $6.235 $6.071 $9.107 309011 Cuerpos cetónicos $1.860 $2.790 $4.320 $6.480 $6.289 $9.434 309012 Electrólitos (sodio, potasio, cloro) c/u, en orina $1.860 $2.790 $4.320 $6.480 $6.289 $9.434 309013 Microalbuminuria cuantitativa $3.620 $5.430 $12.754 $19.131 $18.558 $27.837 309015 Fósforo cuantitativo en orina $2.420 $3.630 $12.767 $19.150 $18.573 $27.860 309016 Glucosa (cuantitativo), en orina $1.600 $2.400 $3.382 $5.073 $4.945 $7.418 309017 Hidroxiprolina en orina $5.500 $8.250 $12.577 $18.865 $18.290 $27.435 309020 Nitrógeno ureico o urea en orina (cuantitativo) $1.010 $1.515 $4.157 $6.235 $6.071 $9.107 309022 Orina completa, (incluye cód. 03-09-023 y 03-09-024) $2.290 $3.435 $4.626 $6.939 $6.744 $10.116 309023 Orina, físico-químico ( aspecto, color, densidad, ph, proteínas, $1.460 $2.190 $3.690 $5.535 $5.382 $8.073 309024 Orina, sedimento (proc. aut.) $1.330 $1.995 $2.869 $4.303 $4.193 $6.290 309027 Porfirinas, c/u $2.480 $3.720 $5.740 $8.610 $8.355 $12.533 309028 Proteína (cuantitativa), en orina $2.130 $3.195 $4.157 $6.235 $6.071 $9.107 309029 Proteínas de Bence-Jones prueba térmica $1.460 $2.190 $3.382 $5.073 $4.945 $7.418 309030 Urobilinógeno (cuantitativo) $2.420 $3.630 $6.194 $9.291 $8.355 $12.533 309501 Mucopolisacaridos Urinarios $107.026 $160.539 $90.136 $135.204 $107.026 $160.539 309502 Melanogenuria (test de cloruro férrico) $6.071 $9.107 $4.157 $6.235 $6.071 $9.107 702001 Preparación de glóbulos rojos, plasma, plaquetas o crioprecipi $9.740 $14.610 $36.604 $54.906 $50.963 $76.445 4010 RX Simple 401002 Partes blandas; laringe lateral; cavum rinofaríngeo (rinofarinx) $11.730 $17.595 $23.934 $35.901 $31.903 $47.855 401004 Tórax, proyección complementaria en el mismo examen (oblic $8.450 $12.675 $16.822 $25.233 $22.422 $33.633 401006 Estudio radiológico de corazón (incluye fluoroscopia, telerradio $25.300 $37.950 $41.185 $61.777 $55.876 $83.814 401008 Tórax, radiografía con equipo móvil fuera del departamento de $12.560 $18.840 $27.053 $40.579 $36.050 $54.075 401009 Tórax simple (frontal o lateral) (incluye fluoroscopía) (1 proy.) $12.560 $18.840 $19.157 $28.735 $26.208 $39.312 401010 Mamografía bilateral (4 exp.) $26.780 $40.170 $58.972 $88.458 $95.463 $143.195 401011 Marcación preoperatoria de lesiones de la mama (4 exp.) $28.000 $42.000 $56.027 $84.040 $74.653 $111.980 401012 Radiografía de mama, pieza operatoria (1 exp.) $8.450 $12.675 $16.822 $25.233 $22.422 $33.633 401013 Abdomen simple (1 proyección) (1 exp.) ( con equipo estático o $11.260 $16.890 $18.272 $27.408 $24.784 $37.176 401014 Abdomen simple, proyección complementaria en el mismo exa $8.450 $12.675 $17.000 $25.500 $22.657 $33.986 401015 Colangiografía intra o postoperatoria (por sonda T, o similar) $23.420 $35.130 $43.161 $64.741 $56.667 $85.001 401018 Enema baritada del colon (incluye llene y control postvaciamie $47.230 $70.845 $77.681 $116.521 $103.496 $155.244 401019 Enema baritada del colon o intestino delgado, doble contraste $53.170 $79.755 $89.142 $133.713 $118.480 $177.720 401020 Esófago simple (incluye pesquisa de cuerpo extraño) (proc.aut $21.020 $31.530 $34.366 $51.549 $45.851 $68.777 401021 Esófago, estómago y duodeno, doble contraste (15 exp.) $46.770 $70.155 $78.440 $117.660 $104.265 $156.398

CODIGO DESCRIPCION Habil Habil 401022 Estudio de deglución faríngea ( 6 exp.) $21.020 $31.530 $34.366 $51.549 $45.851 $68.777 401023 Estudio intestino delgado (6 exp.) $37.520 $56.280 $77.790 $116.685 $101.365 $152.048 401024 Esófago, estómago y duodeno, simple en niños (8 exp.) $34.620 $51.930 $72.060 $108.090 $93.863 $140.795 401521 Pielografia De Eliminacion Con $133.576 $200.364 $102.522 $153.783 $133.576 $200.364 401027 Pielografía de eliminación o descendente: incluye renal y vesic $50.980 $76.470 $79.942 $119.913 $107.246 $160.869 401028 Renal simple (proc. aut.) (1 exp.) $10.800 $16.200 $19.365 $29.047 $25.943 $38.915 401029 Vesical simple o perivesical (proc. aut.) (1 exp.) $9.300 $13.950 $17.000 $25.500 $22.719 $34.079 401030 Agujeros ópticos, ambos lados (2 proy.) (2 exp.) $18.670 $28.005 $32.463 $48.694 $43.654 $65.481 401031 Cavidades perinasales, órbitas, articulaciones temporomandib $12.560 $18.840 $21.375 $32.062 $28.821 $43.232 401032 Cráneo frontal y lateral (2 exp.) $13.260 $19.890 $21.362 $32.043 $29.008 $43.512 401033 Cráneo, cada proyección especial: axial, base, Towne, tangenci $9.300 $13.950 $16.809 $25.213 $22.501 $33.752 401035 Oído, uno o ambos (2-4 proy.) (2-4 exp.) $16.940 $25.410 $36.276 $54.414 $48.366 $72.549 401040 Silla turca frontal y lateral (2 exp.) $15.440 $23.160 $24.998 $37.497 $33.954 $50.931 401042 Columna cervical o atlas-axis (frontal y lateral) (2 exp.) $12.560 $18.840 $20.607 $30.910 $27.913 $41.870 401043 Columna cervical (frontal, lateral y oblicuas) (4 proy.) (4 exp.) $22.430 $33.645 $37.564 $56.346 $50.774 $76.161 401044 Columna cervical funcional adicional (2 exp.) $12.560 $18.840 $23.934 $35.901 $31.903 $47.855 401045 Columna dorsal o dorsolumbar localizada,parrilla costal adulto $14.780 $22.170 $23.917 $35.875 $32.468 $48.702 401046 Columna lumbar o lumbosacra (ambas incluyen quinto espacio $21.700 $32.550 $34.089 $51.133 $46.472 $69.708 401047 Columna lumbar o lumbosacra funcional (2 exp.) $18.670 $28.005 $34.489 $51.733 $46.033 $69.050 401048 Columna lumbar o lumbosacra, oblicuas adicionales (2 exp.) $12.560 $18.840 $23.934 $35.901 $31.903 $47.855 401049 Columna total o dorsolumbar, panorámica con folio graduado $16.880 $25.320 $27.909 $41.863 $37.757 $56.636 401051 Pelvis, cadera o coxofemoral,c/u (1 exp.). $9.740 $14.610 $16.985 $25.477 $22.814 $34.221 401052 Pelvis, cadera o coxofemoral, proyecciones especiales; (rotació $9.300 $13.950 $16.809 $25.213 $22.501 $33.752 401053 Sacrocoxis o articulaciones sacroilíacas, c/u (2-3 exp.) $14.020 $21.030 $24.628 $36.942 $33.076 $49.614 401054 Brazo, antebrazo, codo, muñeca, mano, dedos, pie o similar (fr $11.260 $16.890 $18.789 $28.183 $25.410 $38.115 401055 Clavícula (2 exp.) $13.040 $19.560 $21.730 $32.595 $29.369 $44.054 401056 Edad ósea : carpo y mano (1 exp.) $9.300 $13.950 $16.809 $25.213 $22.501 $33.752 401058 Estudio de escafoides $14.020 $21.030 $24.628 $36.942 $33.076 $49.614 401059 Estudio muñeca o tobillo (front.,lateral y oblicuas; 4 exp.) $13.120 $19.680 $23.166 $34.749 $31.106 $46.659 401060 Hombro, fémur, rodilla, pierna, costilla o esternón ( frontal y la $13.120 $19.680 $23.372 $35.058 $31.356 $47.034 401062 Proyecciones especiales oblicuas u otras en hombro, brazo, co $9.300 $13.950 $16.809 $25.213 $22.501 $33.752 401063 Túnel intercondíleo o radio-carpiano $9.300 $13.950 $16.809 $25.213 $22.501 $33.752 401064 Apoyo fluoroscópico a procedimientos intraoperatorios y/o bio $9.300 $13.950 $18.818 $28.227 $25.081 $37.622 401070 Tórax (frontal y lateral) (incluye fluoroscopía) (2 proy. panorám $23.100 $34.650 $36.276 $54.414 $49.444 $74.166 401110 Mamografía unilateral (2 exp.) $15.940 $23.910 $42.307 $63.460 $47.490 $71.235 401130 Proyección complementaria de mamas (axilar u otras), c/u $6.080 $9.120 $11.641 $17.461 $14.488 $21.732 401151 Pelvis, Cadera o Coxofemoral de RN, Lactante o niño menor de $9.740 $14.610 $17.164 $25.746 $23.032 $34.548 4020 RX Complejo

CODIGO DESCRIPCION Habil Habil 402005 Galactografía, un lado (a.c. 20-01-012) (3 exp.) $13.460 $20.190 $23.917 $35.875 $32.045 $48.068 402008 Colangiopancreatografía endoscópica (a.c.18-01-018; 5-7 exp) $35.970 $53.955 $65.473 $98.209 $87.576 $131.364 402009 Fistulografía (a.c. 18-01-020) (3 exp.) $9.010 $13.515 $17.623 $26.434 $22.980 $34.470 402011 Histerosalpingografía (a.c. 20-01-013) (4 exp.; incluye prueba d $27.490 $41.235 $46.800 $70.200 $62.083 $93.125 402012 Pielografía ascendente (a.c. 19-01-015) (3 exp.) $29.980 $44.970 $51.183 $76.774 $67.870 $101.805 402014 Uretro y/o cistouretrografía miccional retrógrada (a.c. 19-01-0 $29.980 $44.970 $49.635 $74.452 $66.090 $99.135 402017 Neumoartrografía de cadera, hombro, codo, muñeca, etc., c/u $35.970 $53.955 $57.843 $86.764 $77.325 $115.988 402018 Neumoartrografía de rodilla (a.c. 21-01-002) (14 exp.) $44.940 $67.410 $83.845 $125.767 $109.922 $164.883 402019 Angiografía selectiva de carótida externa o interna (a.c 17-01-0 $39.970 $59.955 $93.842 $140.763 $125.068 $187.602 402020 Angiografía selectiva medular (a.c 17-01-024) $39.970 $59.955 $93.842 $140.763 $125.068 $187.602 402022 Angioplastia intraluminal coronaria. procedimiento radiológico $69.890 $104.835 $512.152 $768.228 $682.452 $1.023.678 402023 Angioplastia intraluminal periférica. procedimiento radiológico $49.920 $74.880 $445.628 $668.442 $593.811 $890.717 402024 Aortografía con AOT o cineangiografía (a.c. 17-01-022) $54.500 $81.750 $138.988 $208.482 $185.215 $277.823 402025 Arteriografía de cada extremidad, (a.c.17-01-023) $35.970 $53.955 $84.544 $126.816 $112.659 $168.989 402027 Arteriografía selectiva con AOT o cineangiografía (pulmonar, re $63.410 $95.115 $138.899 $208.348 $185.105 $277.658 402506 Arteriografia Carotida Por Pun $125.068 $187.602 $93.842 $140.763 $125.068 $187.602 402029 Arteriografía Carótida vertebral por cateterización (de la subcla $39.970 $59.955 $93.842 $140.763 $125.068 $187.602 402030 Cinecoronariografía (a.c. 17-01-019) $54.500 $81.750 $183.558 $275.337 $244.581 $366.872 402031 Embolización o balonización (a.c. de la angiografía correspond $29.980 $44.970 $63.345 $95.017 $84.433 $126.650 402032 Instalación de catéter o sonda intracardíaca, control por radiól $27.010 $40.515 $42.856 $64.284 $58.316 $87.474 402033 Ventriculografía derecha y/o izquierda (a.c. 17-01-011, 17-01-0 $54.500 $81.750 $183.558 $275.337 $244.581 $366.872 402507 Vertebral Por Puncion Percutan $125.068 $187.602 $93.842 $140.763 $125.068 $187.602 402035 Cavografía (a.c. 17-01-025) $27.010 $40.515 $63.374 $95.061 $84.478 $126.717 402038 Flebografía extremidad inferior o superior, un lado (a.c. 17-01- $24.480 $36.720 $57.520 $86.280 $76.640 $114.960 402050 Mielografía por punción lumbar con contraste hidrosoluble (a. $39.970 $59.955 $68.370 $102.555 $92.131 $138.197 402513 Arteriografia De Cada Extremid $113.207 $169.811 $84.957 $127.435 $113.207 $169.811 402514 Carotida Por Puncion Percutane $91.661 $137.492 $68.798 $103.197 $91.661 $137.492 4030 Scanner 403001 Cerebro (30 cortes 8-10 mm.) $79.340 $119.010 $236.568 $354.852 $343.986 $515.979 403002 Silla turca e hipófisis (20 cortes 2 mm) $88.430 $132.645 $218.256 $327.384 $282.384 $423.576 403003 Angulo Ponto Cerebeloso (40 Cortes 2Mm.) $72.930 $109.395 $218.437 $327.655 $282.649 $423.974 403004 Cortes Coronales Complementarios (10 Cortes 2 $26.780 $40.170 $90.733 $136.099 $117.385 $176.078 403006 Temporal-Oido (Incluye Coronales) (40 Cortes $72.930 $109.395 $218.437 $327.655 $282.649 $423.974 403007 Orbitas Maxilofacial (Incluye Coronales) (40 $88.430 $132.645 $218.256 $327.384 $282.384 $423.576 403008 Columna Cervical (4 Espacios - 5 Vertebras ) $96.850 $145.275 $265.602 $398.403 $343.674 $515.511 403009 Columna Dorsal O Lumbar (3 Espacios - 4 Verte $88.380 $132.570 $218.256 $327.384 $282.384 $423.576 403010 Cada Espacio Adicional (10 Cortes 2-4 Mm.) $25.280 $37.920 $90.748 $136.122 $117.449 $176.174 403011 Tac Con Mielografia (A.C. 11-0 $343.611 $515.417 $265.558 $398.337 $343.611 $515.417

CODIGO DESCRIPCION Habil Habil 403012 Cuello, Partes Blandas (30 Cortes, 4-8 Mm.) $72.930 $109.395 $218.437 $327.655 $282.649 $423.974 403013 Torax Total (30 Cortes 8-10 Mm.) $114.300 $171.450 $265.392 $398.088 $343.407 $515.111 403014 Abdomen (Higado, Vias Y Vesicula Biliar, Panc $106.990 $160.485 $236.568 $354.852 $343.518 $515.277 403016 Pelvis (28 Cortes, 8-10 Mm.) $68.050 $102.075 $218.511 $327.766 $282.761 $424.142 403017 Extremidades, Estudio Localizado (30 Cortes 2 $61.760 $92.640 $218.572 $327.858 $282.806 $424.209 403101 Angiotac De Cerebro $92.350 $138.525 $376.395 $564.592 $447.589 $671.384 403102 Angiotac De Torax $131.360 $197.040 $382.474 $573.711 $454.796 $682.194 403103 Angiotac De Abdomen $125.070 $187.605 $376.395 $564.592 $447.589 $671.384 404002 Ecografia Obstetrica $8.580 $12.870 $18.707 $28.060 $24.439 $36.659 4040 Ecotomografía 404003 Ecotomografia Abdominal (Incluye Higado, Via $31.490 $47.235 $49.877 $74.815 $66.766 $100.149 404004 Ecotomografia Como Apoyo A Cirugia, O A Proce $19.410 $29.115 $48.310 $72.465 $63.152 $94.728 404005 Ecotomografia Transvaginal O Transrectal $17.520 $26.280 $67.678 $101.517 $84.495 $126.743 404006 Ecotomografia Ginecologica, Pelviana Femenina $16.690 $25.035 $67.678 $101.517 $84.495 $126.743 404007 Ecotomografia Transvaginal Para Seguimiento D $24.370 $36.555 $74.431 $111.646 $97.325 $145.988 404008 Ecotomografia Para Seguimiento De Ovulacion, $24.370 $36.555 $74.431 $111.646 $97.325 $145.988 404009 Ecotomografia Pelvica Masculina (Incluye Veji $17.520 $26.280 $33.388 $50.082 $43.654 $65.481 404010 Ecotomografia Renal (Bilateral), O De Bazo $21.890 $32.835 $37.081 $55.621 $49.178 $73.767 404011 Ecotomografia Cerebral (R.N. O Lactante) $21.890 $32.835 $70.543 $105.814 $92.208 $138.312 404012 Ecotomografia Mamaria Bilateral $21.890 $32.835 $60.352 $90.528 $78.892 $118.338 404013 Ecotomografia Ocular Bidimensional, Uno O Amb $21.890 $32.835 $37.081 $55.621 $49.178 $73.767 404014 Ecotomografia Testicular (Uno O Ambos) $21.890 $32.835 $37.081 $55.621 $49.178 $73.767 404015 Ecotomografia Tiroidea $21.890 $32.835 $40.064 $60.096 $52.636 $78.954 404016 Ecotomografia Vascular Periferica, Articular $21.890 $32.835 $67.544 $101.316 $88.266 $132.399 404550 Ecot. Transvaginal O Gineco C/ $108.403 $162.605 $82.933 $124.399 $108.403 $162.605 404118 Ecotomografia Vascular Periferica (Bilateral) $71.740 $107.610 $116.862 $175.293 $155.846 $233.769 404119 Ecotomografia Carotidea Bilateral $71.740 $107.610 $116.862 $175.293 $155.846 $233.769 404120 Ecotomografia Trancraneal $71.740 $107.610 $116.862 $175.293 $155.846 $233.769 404121 Ecotomografia Abdominal O De Vasos Testicular $71.740 $107.610 $116.862 $175.293 $155.846 $233.769 404122 Ecotomografia Doppler De Vasos Placentarios $71.740 $107.610 $116.862 $175.293 $159.601 $239.402 4050 Resonancia Magnética 405001 Resonancia Magnética De Cráneo-Cerebro $153.170 $229.755 $310.953 $466.429 $426.543 $639.815 405002 Resonancia Magnética De Silla Turca $153.170 $229.755 $329.200 $493.800 $451.577 $677.366 405003 Resonancia Magnética De Orbitas $145.280 $217.920 $292.652 $438.978 $401.445 $602.168 405004 Resonancia Magnética De Articulaciones Témporo Mandibular $145.280 $217.920 $365.829 $548.743 $501.822 $752.733 405005 Resonancia Magnética De Columna Cervical $153.170 $229.755 $329.200 $493.800 $451.577 $677.366 405006 Resonancia Magnética De Columna Dorsal $153.170 $229.755 $329.200 $493.800 $451.577 $677.366 405007 Resonancia Magnética De Columna Lumbar $153.170 $229.755 $310.953 $466.429 $426.543 $639.815