* As of Nov. 3, 2022 11:58AM
LaboratoryRadiologyDentalOperating / Delivery RoomsAmbulanceRoomsBlood BankMiscellaneous
| LABORATORY FEES AND CHARGES | |
| Services | PhPesos |
| Actual Platelet Count | 40.00 |
| AFB (Other Body Fluids) | 100.00 |
| Albumin | 250.00 |
| Alkaline Phosphatase | 350.00 |
| Amylase | 350.00 |
| Anti-HBe | 1,500.00 |
| Anti – HBs | 700.00 |
| Anti-HCG | 550.00 |
| Anti-Hepatitis B Surface (Anti-HBs) | 700.00 |
| APTT | 600.00 |
| ASO (Anti-Streptolysis O) | 150.00 |
| Autocontrol | 250.00 |
| Autopsy | 10,000.00 |
| B1B2 | 400.00 |
| Beta-HCG(Human Chorionic Gonadotrophin) | 550.00 |
| BHCG | 550.00 |
| Bile Determination | 30.00 |
| Biopsy (Level 1) | 200.00 |
| Biopsy (Level 2) | 300.00 |
| Biopsy (Level 3) | 400.00 |
| Biopsy (Level 4) | 500.00 |
| Biopsy (Level 5) | 600.00 |
| Biopsy (Level 6) | 700.00 |
| Blood Agar Plate | 80.00 |
| Blood Bag Double | 200.00 |
| Blood Bag Single | 100.00 |
| Blood Bag Triple | 300.00 |
| Blood Culture and Sensitivity | 1,650.00 |
| Blood Typing ABO | 100.00 |
| Blood Typing of Mother | 60.00 |
| Blood Typing with Rh Typing | 150.00 |
| Blue Top | 25.00 |
| BNP (Quantitative Test) | 800.00 |
| BSMP | 50.00 |
| BSMP Strip | 150.00 |
| BUA (Blood Uric Acid) | 150.00 |
| BUN | 150.00 |
| CA 125 | 1,500.00 |
| CA 153 | 1,500.00 |
| Cadavers Storage Fee | 1,000.00 |
| Calcium Chemistry | 150.00 |
| Calcium Ion | 220.00 |
| Calcium Serum | 350.00 |
| CBC | 175.00 |
| CBC W/ APC | 200.00 |
| CEA | 1,500.00 |
| Cell Block/Slide | 100.00 |
| Cell Block | 400.00 |
| Chem 8 | 1,330.00 |
| Chem 10 | 1,730.00 |
| Chloride (Cl) | 220.00 |
| Cholesterol | 150.00 |
| CKMB | 300.00 |
| Clotting Time, Bleeding Time | 75.00 |
| Creatinine | 150.00 |
| Crossmatching | 500.00 |
| Crossmatching (Auto Control) | 400.00 |
| CRP | 800.00 |
| CSF and Other Body Fluids | 600.00 |
| Culture and Sensitivity – Blood | 1,650.00 |
| Culture and Sensitivity – CSF | 1,200.00 |
| Culture and Sensitivity (Pleural Fluid) | 1,200.00 |
| Culture and Sensitivity (Sputum) | 1,200.00 |
| Culture and Sensitivity – Urine | 1,350.00 |
| Culture and Sensitivity (Wound Discharge) | 1,200.00 |
| DAT (Direct Anti Globulin Test) | 250.00 |
| Dengueline | 700.00 |
| Direct Bilirubin | 250.00 |
| Direct Coombs Test | 200.00 |
| Drug Testing | 250.00 |
| ESR (Erythocyte Sedimentation Rate) | 150.00 |
| FBS (Fasting Blood Sugar) | 150.00 |
| FFP | 900.00 |
| FNAB/Cytology | 250.00 |
| Fine Needle Aspiration Smears/Slide | 50.00 |
| Fine Needle Aspiration Biopsy | 250.00 |
| Fluid Analysis | 600.00 |
| Frozen Section(Large Definitive) | 1,300.00 |
| Frozen Section(Small Definitive) | 1,000.00 |
| FT4 | 550.00 |
| Globulin | 150.00 |
| Handling Fee | 1,500.00 |
| HBA1C | 875.00 |
| HBC | 600.00 |
| HBe | 1,500.00 |
| HBeAg | 1,500.00 |
| HBsAg | 150.00 |
| HBsAg – MEIA | 450.00 |
| HCV ELISA | 460.00 |
| HCV PA | 450.00 |
| HDL (High Density Lipoprotein) | 250.00 |
| Hemoglobin + Hematocrit | 100.00 |
| Histopath Blocks (Handling Fee) | 200.00 |
| Histopath Slide (Handling Fee) | 50.00 |
| HIV ELISA | 450.00 |
| HIV PA | 350.00 |
| Gram Staining | 100.00 |
| Indirect Bilirubin | 150.00 |
| Kidney UTZ | 310.00 |
| KOH | 100.00 |
| Lavender Top | 20.00 |
| LDL | 150.00 |
| Leptospira Screening Test | 700.00 |
| Lipid Profile | 730.00 |
| Magnesium | 350.00 |
| NS1 Ag | 1,000.00 |
| Occult Blood | 75.00 |
| OGTT | 300.00 |
| PAPS (PAP Smear)/Slide | 50.00 |
| PAP Smear | 120.00 |
| PBS (Peripheral Blood Smear) | 200.00 |
| Phosphorus | 350.00 |
| Platelet Concentrate (No Donor) | 900.00 |
| Platelet Concentrate (With Donor) | 900.00 |
| Pleural Fluid Analysis | 600.00 |
| Potassium (K) | 220.00 |
| PRBC | 1,100.00 |
| Pregnancy Test (Preg Test) | 150.00 |
| Prostate Specific Antigen | 1,300.00 |
| PT (Prothrombin Time) | 500.00 |
| PT with INR | 600.00 |
| PTT (Partial Prothrombine Time) | 600.00 |
| RBS | 150.00 |
| Red Top / EDTA | 20.00 |
| Reticulocyte Count | 150.00 |
| Rh Typing | 60.00 |
| Routine Fecalysis | 100.00 |
| Routine Fecalysis Concentration Technique | 150.00 |
| Routine Urinalysis | 150.00 |
| Routine Urinalysis 4 Parameter | 150.00 |
| Routine Urinalysis Flow Cytometer with 4 Parameter | 150.00 |
| Routine Urinalysis 10 Parameter | 125.00 |
| Routine Urinalysis Flow Cytometer with 10 Parameter | 175.00 |
| RPR (Rapid-Plasma Regin)/VDRL | 100.00 |
| Screening Fee | 1,500.00 |
| Screening Fees (PRBC) | 1,100.00 |
| Screening Fee (WB) | 1,700.00 |
| SGOT (Serum Glutamic Oxaloacetic Transaminase) | 200.00 |
| SGPT (Serum glutamic Pyruvate Transaminase) | 200.00 |
| SODIUM (Na) | 220.00 |
| Sodium Potassium Chloride | 660.00 |
| Specific Blood Typing (FFP/ PC) | 60.00 |
| Sperm Analysis | 300.00 |
| S. Typhi/Typhidot | 700.00 |
| Surgical Pathology Level I (Gross Exam Only) – Processing Fee | 200.00 |
| Surgical Pathology Level II) (Norma/Incidental)– Processing Fee | 300.00 |
| Surgical Pathology Level III (Small)– Processing Fee | 400.00 |
| Surgical Pathology Level IV (Medium)– Processing Fee | 500.00 |
| Surgical Pathology Level V (Large)– Processing Fee | 600.00 |
| Surgical Pathology Level VI (Extra Large)– Processing Fee | 700.00 |
| Surgical Specimen/Slide | 100.00 |
| T3/FT3 | 550.00 |
| T4/FT4 | 550.00 |
| Test Tube – EDPA/Red Tab | 25.00 |
| Total Bilirubin | 250.00 |
| Total Cholesterol | 150.00 |
| Total Protein | 250.00 |
| TPPA | 200.00 |
| Triglyceride | 180.00 |
| Troponin(Qualitative) I | 450.00 |
| Troponin(Quantitave) I | 800.00 |
| Troponin(Qualitative) T | 650.00 |
| Troponin(Quantitative) T | 800.00 |
| TSH | 550.00 |
| Typhi Dot | 700.00 |
| Urine 10 Parameters | 100.00 |
| Urine Culture and Sensitivity | 1,350.00 |
| Urine Ketones | 25.00 |
| Urine RBC Morphology | 100.00 |
| WBC Diff. Count | 25.00 |
| RADIOLOGY FEES AND CHARGES | |
| Services | PhPesos |
| 1 Breast – UTZ | 380.00 |
| 2 Breast – UTZ | 550.00 |
| Abdomen AP, Translateral (Pedia) | 210.00 |
| Abdomen Decubitus (Left) | 180.00 |
| Abdomen Decubitus (Right) | 180.00 |
| Abdomen Lateral | 200.00 |
| Abdomen Supine | 180.00 |
| Ankle Joint APL (Left) | 120.00 |
| Ankle Joint APL (Right) | 120.00 |
| Ankle Mortise (Left) | 120.00 |
| Ankle Mortise (Right) | 120.00 |
| Apicogram (Lordotic View) | 120.00 |
| Baby Gram | 200.00 |
| Barium Enema | 1,000.00 |
| Barium Swallow | 500.00 |
| Biophysical Scoring (BPS) – UTZ | 520.00 |
| Cald Well | 150.00 |
| Cardiac Series | 350.00 |
| C-ARM (Charity) | 850.00 |
| C-ARM (Philhealth/ Pay) | 1,200.00 |
| Cervical Spine APL | 210.00 |
| Cervico-Thoracic | 370.00 |
| Chest APL (Adult) | 300.00 |
| Chest APL (Pedia) | 210.00 |
| Chest Decubitus (Left) | 180.00 |
| Chest Decubitus (Right) | 180.00 |
| Chest Pedia (1 view) | 150.00 |
| Chest – UTZ | 380.00 |
| Cholangiogram | 600.00 |
| Clavicle AP (Left) | 120.00 |
| Clavicle AP (Right) | 120.00 |
| Cranial – UTZ | 450.00 |
| Cystogram | 600.00 |
| Distal Colonogram | 500.00 |
| ECG | 175.00 |
| Elastogram | 50.00 |
| Elbow Joint APL (Left) | 120.00 |
| Elbow Joint APL (Right) | 120.00 |
| Esophagography/Barium Swallow | 800.00 |
| Facial Bones | 120.00 |
| FAST – UTZ | 480.00 |
| Femur APL (Left) | 200.00 |
| Femur APL (Right) | 200.00 |
| Fetal Aging – UTZ | 450.00 |
| Fistulogram | 500.00 |
| Fluoro-Guided | 500.00 |
| Foot APO (Left) | 120.00 |
| Foot Apol | 180.00 |
| Foot APO (Right) | 120.00 |
| Forearm APL (Left) | 200.00 |
| Forearm APL (Right) | 200.00 |
| Hand APO (Left) | 120.00 |
| Hand APO (Right) | 120.00 |
| HBT – UTZ | 420.00 |
| Heel Bone – Axial / Lateral | 100.00 |
| Hip Joint (Left) | 150.00 |
| Hip Joint (Right) | 150.00 |
| HUMERUS APL (Left) | 200.00 |
| HUMERUS APL (Right) | 200.00 |
| Hysterosalpingography | 800.00 |
| Inguino-Scrotal | 315.00 |
| Knee Joint APL (Left) | 150.00 |
| Knee Joint APL (Right) | 150.00 |
| KUB and Prostate – UTZ | 420.00 |
| KUB (IVP) | 1,000.00 |
| KUB (kidneys and urinary bladder) – UTZ | 420.00 |
| KUB (Plainabd) – x-ray | 150.00 |
| Leg APL (Left) | 200.00 |
| Leg APL (Right) | 200.00 |
| Lower Abd | 480.00 |
| Lower Abdomen – UTZ | 560.00 |
| Lumbar Vertebrae (2 views) | 270.00 |
| Lumbosacral APL | 300.00 |
| Mandible 3 Views – FILM | 320.00 |
| Mastoids (R/L) (FILM) | 280.00 |
| Maxilla Mandible 2 Views | 280.00 |
| Mobile X-Ray 1 or 2 View (Charity) | 150.00 |
| Mobile X-Ray 1 or 2 Views (PHIC/Pay) | 200.00 |
| Mobile X-Ray More than 2 Views (Charity) | 300.00 |
| Mobile X-Ray More than 2 Views (PHIC/Pay Patients) | 350.00 |
| Nasal Bones (Waters/STL) | 200.00 |
| Optic Foramen (R/L) | 300.00 |
| Orbit 2 views | 200.00 |
| Oscalsis APL (Left) | 120.00 |
| Oscalsis APL (Right) | 120.00 |
| Pelvic – UTZ | 420.00 |
| Pelvis AP | 180.00 |
| Plain Abdomen(supine & upright) | 300.00 |
| PNS lat/ waters/ Caldwells | 330.00 |
| Procedure IVP | 1,000.00 |
| Retrograde Pyelography | 800.00 |
| Retrograde Pyelography (RGP) | 800.00 |
| Sacrum / Coccyx APL | 210.00 |
| SCAPULA AP (Left) | 120.00 |
| SCAPULA AP (Right) | 120.00 |
| Scapular Left Y | 170.00 |
| Scapular Right Y | 170.00 |
| Scoliatic Series | 350.00 |
| Shoulder Joint AP (Left) | 120.00 |
| Shoulder Joint AP (Right) | 120.00 |
| Single Organ – UTZ | 280.00 |
| Skull APL | 200.00 |
| Small Intestines Series | 800.00 |
| SMV | 330.00 |
| Soft Tissue Lateral (STL) | 120.00 |
| Submental – UTZ | 350.00 |
| Temporo-Mandibular Bone (Open, Close, Bilat) | 350.00 |
| Thoracic APL | 330.00 |
| Thoracic Cage AP | 180.00 |
| Thoraco – Lumbar APL | 380.00 |
| Thoraco – Lumbosacral APL | 550.00 |
| Thyroid – UTZ | 490.00 |
| Thyroid w/ Elastogram – UTZ | 400.00 |
| Townes | 150.00 |
| Transabdomen (Pelvis) – UTZ | 350.00 |
| Transrectal / Prostate – UTZ | 500.00 |
| Transrectal – UTZ | 490.00 |
| Transvaginal – UTZ | 490.00 |
| Ultrasound Guided Procedures (OPD) – UTZ | 250.00 |
| Ultrasound Guided Procedures (PAY) – UTZ | 250.00 |
| Upper Abdomen – UTZ | 560.00 |
| UPPER GI SERIES | 1,000.00 |
| Waters View | 150.00 |
| Whole Abdomen – UTZ | 650.00 |
| Wrist APL (Left) | 120.00 |
| Wrist APL (Right) | 120.00 |
| Zygoma(SMV) – FILM | 180.00 |
| Ct Scan-Cervical Spine (Contrast) w/o PF | 3,700.00 |
| Ct Scan-Cervical Spine (Plain) w/o PF | 3,100.00 |
| Ct Scan-Chest (High Resolution) w/o PF | 3,375.00 |
| Ct Scan-Chest (Routine) w/o PF | 3,375.00 |
| Ct Scan-Cranial (Contrast) w/o PF | 2,500.00 |
| Ct Scan-Cranial (Plain) w/o PF | 2,500.00 |
| Ct Scan-Ct Guided Biopsy w/o PF | 6,000.00 |
| Ct Scan-Lower/Upper Abdomen (Routine) w/o PF | 3,225.00 |
| Ct Scan-Lumbar Spine (Contrast) w/o PF | 3,700.00 |
| Ct Scan-Lumbar Spine w/o PF | 3,700.00 |
| Ct Scan-Nasopharynx/Osopharynx (Coronal And Axial Cuts) w/o PF | 4,000.00 |
| Ct Scan-Orbit Scan w/o PF | 4,000.00 |
| Ct Scan-Paranasal Sinuses (Coronal And Axial Cuts) w/o PF | 4,000.00 |
| Ct Scan-Pelvis w/o PF | 3,700.00 |
| Ct Scan-Pituitary Fossa (Plain) w/o PF | 2,775.00 |
| Ct Scan-Sella Turcica W/Contrast w/o PF | 2,775.00 |
| Ct Scan-Stonogram w/o PF | 4,700.00 |
| Ct Scan-Temporal Bone (Contrast) w/o PF | 4,050.00 |
| Ct Scan-Temporal Bone (Plain) w/o PF | 4,050.00 |
| Ct Scan-Temporo Mandibular Joint (Plain) w/o PF | 2,775.00 |
| Ct Scan-Thoracic Spine (Contrast) w/o PF | 3,900.00 |
| Ct Scan-Thoracic Spine w/o PF | 3,900.00 |
| Ct Scan-Triple Phase Contrast Study For Liver w/o PF | 6,000.00 |
| Ct Scan-Triple Phase Contrast Study For Liver w/o PF w/ Power Injector Syringe 100ml | 6,960.00 |
| Ct Scan-Whole Abdomen w/o PF | 5,025.00 |
| Ct Scan-Cervical Spine (Contrast) w/o PF | 3,700.00 |
| Ct-Scan-Facial | 4,700.00 |
| DENTAL RATES | |
| Services | PhPesos |
| Alveolectomy (Full) | 8,260.00 |
| Dental X-Ray | 200.00 |
| Gingivectory | 8,020.00 |
| Glassionomer | 165.00 |
| Gum Treatment | 250.00 |
| Incision and Drainage | 8,260.00 |
| Light Cured Composite | 275.00 |
| Odontectomy (Impaction) | 1,500.00 |
| Operculectomy (Pericoronitis) | 300.00 |
| Oral Prophylaxis (Cleaning) | 275.00 |
| Pit and Fissure Sealant Application | 275.00 |
| Reduction and Fixation of Fractured mandible and maxilla (Risdon Wiring) | 1,300.00 |
| Temporary Filling | 110.00 |
| Tooth Extraction (Ordinary) | 100.00 |
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| OPERATING / DELIVERY ROOM RATES | |
| Room Rate | PhPesos |
| Operating Room/Delivery Room Fee RUV 1-10 (Charity) | 450.00 |
| Operating Room/Delivery Room Fee RUV 11-20 (Charity) | 630.00 |
| Operating Room/Delivery Room Fee RUV 11-20 (Pay) | 800.00 |
| Operating Room/Delivery Room Fee RUV 21-30 (Charity) | 810.00 |
| Operating Room/Delivery Room Fee RUV 21-30 (Pay) | 1,378.00 |
| Operating Room/Delivery Room Fee RUV 30 and Below (Phic) | 1,200.00 |
| Operating Room/Delivery Room Fee RUV 31-80 (Charity) | 1,215.00 |
| Operating Room/Delivery Room Fee RUV 31-80 (Pay) | 1,755.00 |
| Operating Room/Delivery Room Fee RUV 31 to 80 (Phic) | 1,500.00 |
| Operating Room/Delivery Room Fee RUV 81-600 (Phic) | 3,500.00 |
| Operating Room/Delivery Room Fee RUV 81+ (Charity) | 3,141.00 |
| Operating Room/Delivery Room Fee RUV 81+ (Pay) | 4,253.00 |
| Operating Room/Delivery Room RUV 1-10 (Pay) | 500.00 |
| AMBULANCE RATES | |
| Services | PhPesos |
| Ambulance(2-D Echo Bay.-Sol.) | 500.00 |
| Ambulance(C.T. Scan Bay.-Sol) | 300.00 |
| Ambulance(C.T. Scan PLT) | 500.00 |
| Ambulance(Dialysis – Bambang) | 800.00 |
| Ambulance(Dialysis Bonfal) | 300.00 |
| Ambulance(Dialysis Solano) | 500.00 |
| Ambulance(UTZ-EEG Bay.-Sol.) | 500.00 |
| Ambulance(UTZ VRH-PLT Hosp.) | 700.00 |
| Ambulance(VRH to A. Castaneda) | 4,600.00 |
| Ambulance(VRH to Ambaguio) | 550.00 |
| Ambulance(VRH to Aritao) | 850.00 |
| Ambulance(VRH to Bagabag) | 750.00 |
| Ambulance(VRH to Baguio) | 7,500.00 |
| Ambulance(VRH to Bambang) | 400.00 |
| Ambulance(VRH to Bayombong) | 75.00 |
| Ambulance(VRH to Diadi) | 1,400.00 |
| Ambulance(VRH to Dupax d.Norte | 700.00 |
| Ambulance(VRH to Dupax d.Sur) | 800.00 |
| Ambulance(VRH to Kasibu) | 1,350.00 |
| Ambulance(VRH to Kayapa) | 1,500.00 |
| Ambulance(VRH to Manila) | 7,500.00 |
| Ambulance(VRH to Quezon) | 550.00 |
| Ambulance(VRH to Santiago) | 1,700.00 |
| Ambulance(VRH to Sta. Fe) | 1,450.00 |
| Ambulance(VRH to Tuguegarao) | 7,500.00 |
| Ambulance(VRH to Villaverde) | 500.00 |
| ROOM RATES | |
| Room and Ward | PhPesos |
| Service Ward | 500.00 |
| PhilHealth Ward | 500.00 |
| Semi-Pay | 1,100.00 |
| Single Room | 2,000.00 |
| Suite Room | 3,000.00 |
| ICUs | 2,000.00 |
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| BLOOD BANK FEES AND CHARGES | |
| Fees and Charges | PhPesos |
| Fresh Frozen Plasma | 900.00 |
| Fresh Whole Blood | 1,500.00 |
| Packed RBC | 1,400.00 |
| Platelet Concentrate (with donor) | 900.00 |
| Platelet Concentrate (without donor) | 1,000.00 |
| Processing Fee (blood bank) | 200.00 |
| Triple Blood Bag | 300.00 |
| Whole Blood | 1,500.00 |
| MISCELLANEOUS FEES AND CHARGES | |
| Fees and Charges | PhPesos |
| Anesthesia Machine | 150.00 |
| Basic IVT | 3,000.00 |
| Oxygen (per Liter) | 0.25 |
| Biometric Scanning With Paper | 200.00 |
| Birth Certificate | 20.00 |
| Cardiac Monitor | 100.00 |
| Cautery Fee | 300.00 |
| Cellphone Charge | 5.00 |
| Certificate | 50.00 |
| Certificate of Confinement | 20.00 |
| Certificate of Employment | 50.00 |
| Certification Fee | 20.00 |
| Circumcision | 600.00 |
| Clinical Abstract | 50.00 |
| Consultation Fee | 200.00 |
| Consultation Fee (New Pt. OPD) | 100.00 |
| Consultation Fee (New Senior Citizen) | 80.00 |
| Consultation Fee (Old Pt. OPD) | 50.00 |
| Consultation Fee – Penadur | 20.00 |
| Consultation Fee (Senior Citizen) | 40.00 |
| Dental Fee | 150.00 |
| Desk Fan | 15.00 |
| Discharge Summary | 20.00 |
| Dressing | 50.00 |
| Droplight/Isollete | 100.00 |
| Electric Airpot | 100.00 |
| ER Consultation Fee | 300.00 |
| Examination Fee (Nursing) | 100.00 |
| Hearing Test | 200.00 |
| Incision and Drainage | 120.00 |
| Incubator | 100.00 |
| Insurance Fee | 50.00 |
| IV Training | 3,000.00 |
| IVT Training | 3,000.00 |
| Laptop Computer/DVD Player | 100.00 |
| Lost OPD Card | 100.00 |
| Lost OPD Card (Sr. Citizen) | 45.00 |
| Mechanical Ventiltor | 100.00 |
| Medical Certificate | 20.00 |
| Medico-Legal Certificate | 50.00 |
| Minor Fee | 300.00 |
| NCP | 1,200.00 |
| Nebulization Fee | 20.00 |
| Negatoscope | 5.00 |
| Neuro Psychiatric Examination | 500.00 |
| Newborn Care | 500.00 |
| New Born Care Package | 1,200.00 |
| Newborn Screening Package | 1,100.00 |
| Non Stress Test (NST) | 200.00 |
| Non Stress Test (Repeat NST) | 100.00 |
| OPD Card (NEW) | 50.00 |
| OPD CARD (Re-NEW) | 30.00 |
| OR Records | 20.00 |
| Ozonation | 120.00 |
| Papsmear | 120.00 |
| Patient ID (Lost) | 50.00 |
| Phototherapy | 100.00 |
| PT w/ Modality & Exercise | 200.00 |
| PT w/o Modality(Pure Exercise) | 150.00 |
| Pulse Oximeter | 10.00 |
| Qualifying Fee | 100.00 |
| Removal of Cast | 50.00 |
| Removal of Sutures | 50.00 |
| Rice Cooker | 50.00 |
| ROS – Removal of Sutures | 50.00 |
| Scanning | 50.00 |
| Stand Fan | 30.00 |
| Statement of Account | 20.00 |
| Suction Machine Use | 50.00 |
| Surgical Memo | 20.00 |
| Table Rental | 50.00 |
| Thermos | 100.00 |
| Use of Scope | 500.00 |
| Utility Fee | 1,500.00 |
| Watchers ID | 50.00 |
| Xerox Fee | 10.00 |
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