
Importante: El valor final a pagar puede variar según la cobertura de su previsión, convenio vigente, prestaciones efectivamente realizadas y seguros complementarios asociados.
Seleccione el tipo de prestación que desea buscar:
| Código CHP | Código Fonasa | Nombre prestación | Valor particular | Valor Fonasa |
|---|---|---|---|---|
| 90-01-001-00 | 0101001 | CONSULTA CIRUGIA GENERAL | $23.000 | $19.220 |
| 90-01-011-00 | 0101313 | CONSULTA CGIA GRAL Y CABEZA Y CUELLO | $23.000 | $19.220 |
| 90-01-012-00 | 0101314 | CONSULTA CIRUGIA CARDIOVASCULAR | $23.000 | $19.220 |
| 90-01-013-00 | 0101319 | CONSULTA CGIA GRAL Y COLOPROCTOLOGIA | $23.000 | $19.220 |
| 90-01-014-00 | 0101323 | CONSULTA CGIA GENERAL Y GASTROENTEROLOGI | $23.000 | $19.220 |
| 90-01-015-00 | — | CONSULTA CGIA GRAL Y MAMA | $23.000 | $19.220 |
| 90-01-016-00 | 0101315 | CONSULTA CGIA GRAL Y TORAX | $23.000 | $19.220 |
| 90-01-017-00 | 0101318 | CONSULTA VASCULAR PERIFERICO | $23.000 | $19.220 |
| 90-01-018-00 | 0101310 | CONSULTA CGIA INFANTIL Y ORTOPEDIA | $23.000 | $19.220 |
| 90-01-019-00 | — | CONSULTA CIRUGIA PLASTICA REPARADORA | $40.000 | $40.000 |
| 90-01-020-00 | 0101201 | CONSULTA DERMATOLOGIA | $32.000 | $27.310 |
| 90-01-021-00 | 0101202 | CONSULTA GERIATRIA | $32.000 | $27.310 |
| 90-01-022-00 | 0101308 | CONSULTA GINECOLOGIA Y OBSTETRICIA | $23.000 | $19.220 |
| 90-01-023-00 | 0101001 | CONSULTA MEDICINA ADULTOS ELECTIVA | $23.000 | $15.130 |
| 90-01-024-00 | 0101001 | CONSULTA MEDICINA INFANTIL ELECTIVA | $23.000 | $15.130 |
| 90-01-025-00 | 0101001 | CONSULTA MED GRAL ADULTO | $23.000 | $15.130 |
| 90-01-026-00 | 0101001 | CONSULTA MED GRAL INFANTIL | $23.000 | $15.130 |
| 90-01-027-00 | 0101307 | CONSULTA MEDICINA INTERNA | $23.000 | $19.220 |
| 90-01-028-00 | 0101301 | CONSULTA CARDIOLOGIA | $23.000 | $19.220 |
| 90-01-029-00 | 0101207 | CONSULTA ENDOCRINOLOGIA | $32.000 | $27.310 |
| 90-01-030-00 | 0101321 | CONSULTA BRONCOPULMONAR ADULTO | $23.000 | $19.220 |
| 90-01-031-00 | 0101323 | CONSULTA GASTROENTEROLOGIA | $23.000 | $19.220 |
| 90-01-032-00 | 0101302 | CONSULTA MED INTERNA Y HEMATOLOGIA | $23.000 | $19.220 |
| 90-01-033-00 | 0101326 | CONSULTA MED INTERNA Y NEFROLOGIA | $23.000 | $19.220 |
| 90-01-034-00 | 0101206 | CONSULTA REUMATOLOGIA | $32.000 | $27.310 |
| 90-01-035-00 | 0101203 | CONSULTA NEUROCIRUGIA | $32.000 | $27.310 |
| 90-01-036-00 | 0101209 | CONSULTA NEUROLOGIA | $32.000 | $27.310 |
| 90-01-037-00 | 0101210 | CONSULTA NEUROLOGIA INFANTIL | $32.000 | $27.310 |
| 90-01-038-00 | 0101204 | CONSULTA OFTALMOLOGIA | $32.000 | $27.310 |
| 90-01-040-00 | 0101211 | CONSULTA ONCOLOGIA | $32.000 | $27.310 |
| 90-01-041-00 | 0101205 | CONSULTA OTORRINOLARINGOLOGIA | $32.000 | $27.310 |
| 90-01-042-00 | 0101309 | CONSULTA PEDIATRIA GRAL | $23.000 | $19.220 |
| 90-01-043-00 | 0101301 | CONSULTA CARDIOLOGIA INFANTIL | $23.000 | $19.220 |
| 90-01-044-00 | 0101208 | CONSULTA ENDOCRINOLOGIA INFANTI | $32.000 | $27.310 |
| 90-01-045-00 | 0101322 | CONSULTA BRONCOPULMONAR INFANTIL | $23.000 | $19.220 |
| 90-01-046-00 | 0101324 | CONSULTA GASTROENTEROLOGIA INFANTIL | $23.000 | $19.220 |
| 90-01-047-00 | 0101302 | CONSULTA HEMATOLOGIA INFANTIL | $23.000 | $19.220 |
| 90-01-048-00 | 0101327 | CONSULTA NEFROLOGIA INFANTIL | $23.000 | $19.220 |
| 90-01-049-00 | 0101310 | CONSULTA TRAUMATOLOGIA ADULTOS | $23.000 | $19.220 |
| 90-01-050-00 | 0101330 | CONSULTA URGENCIA | $33.120 | $33.120 |
| 90-01-053-00 | — | INTERCONSULTA PSIQUIATRIA | $50.000 | $50.000 |
| 90-01-054-00 | — | LLAMADA ESPECIALISTA EN SERV URGENCIAS | $46.575 | $46.575 |
| 90-01-055-00 | 0101311 | CONSULTA UROLOGIA | $32.000 | $27.310 |
| 90-01-056-00 | 0101332 | CONSULTA GINECOLOGIA INFANTIL | $23.000 | $19.220 |
| 90-01-058-00 | — | CONSULTA UROLOGIA GENERAL | $23.000 | $15.130 |
| 90-01-060-00 | 0101320 | CONSULTA DIABETES Y NUTRICION | $23.000 | $19.220 |
| 90-01-061-00 | 0101304 | CONSULTA INMUNOLOGIA | $23.000 | $19.220 |
| 90-01-063-00 | 0101317 | CONSULTA CIRUGIA INFANTIL | $23.000 | $19.220 |
| 90-01-064-00 | 0101310 | CONSULTA TRAUMATOLOGIA INF | $23.000 | $19.220 |
| 90-01-065-00 | 0901005 | CONSULTA PSIQUIATRIA | $50.000 | $46.690 |
| 90-01-066-00 | 0101212 | CONSULTA PSIQUIATRIA 1° CONS FONASA | $50.000 | $46.690 |
| 90-01-067-00 | 0101213 | CONSULTA PSIQUIATRIA INFANTIL | $50.000 | $46.690 |
| 90-01-070-00 | 0902002 | CONSULTA PSICOLOGO CLINICO ADULTOS (SESI | $35.000 | $20.980 |
| 90-01-072-00 | 0902002 | CONSULTA PSICOLOGO CLINICO INFANTIL (SES | $35.000 | $20.980 |
| 90-01-073-00 | — | CONSULTA NUTRICIONISTA | $13.400 | $14.870 |
| 90-01-074-00 | — | CONSULTA FAD | $13.400 | $15.130 |
| 90-01-075-00 | 0101313 | CIRUGÍA MAXILO FACIAL | $23.000 | $19.220 |
| 90-01-076-00 | — | CONSULTA MATRONA | $12.000 | $10.000 |
| 90-01-078-00 | — | TERAPIA OCUPACIONAL | $13.400 | $9.500 |
| 90-01-079-00 | 0101306 | CONSULTA FISIATRIA | $23.000 | $19.220 |
| 90-01-084-00 | 0101329 | CONSULTA ANESTESIOLOGIA | $23.000 | $19.220 |
| Código CHP | Código Fonasa | Nombre prestación | Valor particular | Valor Fonasa |
|---|---|---|---|---|
| 04-01-001-00 | 0401001 | SIALOGRAFIA (4 EXP.)Radiografía de las glándulas salivales "sialografía" | $41.660 | $41.660 |
| 04-01-002-00 | 0401002 | PARTES BLANDAS LARINGE LATERAL CAVUM RRadiografía de partes blandas, laringe lateral, cavum rinofaríngeo (rinofarinx). | $15.570 | $15.570 |
| 04-01-004-00 | 0401004 | TORAX, PROYECCION COMPLEMENTARIA EN EL MRadiografía de tórax, proyección complementaria (oblicuas, selectivas u otras) | $14.340 | $14.340 |
| 04-01-008-00 | 0401008 | TORAX, RADIOGRAFIA CON EQUIPO MOVIL FUERRadiografía de tórax frontal o lateral con equipo móvil fuera del departamento de rayos. | $20.270 | $20.270 |
| 04-01-009-00 | 0401009 | TORAX SIMPLE (FRONTAL O LATERAL) (INCLUYRadiografía de tórax simple frontal o lateral | $17.680 | $17.680 |
| 04-01-010-00 | 0401010 | MAMOGRAFIA BILATERAL (4 EXP.)Mamografía bilateral | $37.600 | $37.600 |
| 04-01-011-00 | 0401011 | MARCACION PREOPERATORIA DE LESIONES DE LMarcación preoperatoria de lesiones de la mama | $51.620 | $51.620 |
| 04-01-012-00 | 0401012 | RADIOGRAFIA DE MAMA, PIEZA OPERATORIA (1Radiografía de mama, pieza operatoria | $15.150 | $15.150 |
| 04-01-013-00 | 0401013 | ABDOMEN SIMPLE (1 PROYECCION) (1 EXP.) (Radiografía de Abdomen Simple | $16.210 | $16.210 |
| 04-01-014-00 | 0401014 | ABDOMEN SIMPLE, PROYECCION COMPLEMENTARIRadiografía de abdomen simple, proyección complementaria (lateral y/o oblicua) | $11.680 | $11.680 |
| 04-01-015-00 | 0401015 | COLANGIOGRAFIA INTRA O POSTOPERATORIA (PColangiografía intra o postoperatoria (por sonda T, o similar) | $37.790 | $37.790 |
| 04-01-020-00 | 0401020 | ESOFAGO SIMPLE (INCLUYE PESQUISA DE CUEREsofagograma (incluye pesquisa de cuerpo extraño) (proc.aut.) | $35.460 | $35.460 |
| 04-01-022-00 | 0401022 | ESTUDIO DE DEGLUCION FARINGEA ( 6 EXP.)Estudio radiológico de deglución faríngea | $29.550 | $29.550 |
| 04-01-028-00 | 0401028 | RENAL SIMPLE (PROC. AUT.) (1 EXP.)Radiografía renal simple (proc. aut.) | $14.910 | $14.910 |
| 04-01-029-00 | 0401029 | VESICAL SIMPLE O PERIVESICAL (PROC. AUT.Radiografía vesical simple o perivesical (proc. aut.) | $12.850 | $12.850 |
| 04-01-031-00 | 0401031 | CAVIDADES PERINASALES, ORBITAS, ARTICULARadiografía de cavidades perinasales, órbitas, articulaciones temporomandibulares, huesos propios de la nariz, malar, maxilar, arco cigomático y cara | $17.550 | $17.550 |
| 04-01-031-03 | 0401031 | HUESOS PROPIOSRadiografía de cavidades perinasales, órbitas, articulaciones temporomandibulares, huesos propios de la nariz, malar, maxilar, arco cigomático y cara | $17.550 | $17.550 |
| 04-01-032-00 | 0401032 | CRANEO FRONTAL Y LATERAL (2 EXP.)Radiografía de cráneo frontal y lateral | $18.350 | $18.350 |
| 04-01-033-00 | 0401033 | CRANEO, CADA PROYECCION ESPECIAL: AXIAL,Radiografía de Cráneo proyección especial de base de cráneo (Towne) | $12.860 | $12.860 |
| 04-01-035-00 | 0401035 | OIDO, UNO O AMBOS (4 PROY.) (4 EXP.)Radiografía de oído, unilateral o bilateral | $22.210 | $22.210 |
| 04-01-040-00 | 0401040 | SILLA TURCA FRONTAL Y LATERAL (2 EXP.)Radiografía de silla turca frontal y lateral | $20.510 | $20.510 |
| 04-01-042-00 | 0401042 | COLUMNA CERVICAL O ATLAS-AXIS (FRONTAL YRadiografía de columna cervical o atlas-axis (frontal y lateral) | $17.680 | $17.680 |
| 04-01-043-00 | 0401043 | COLUMNA CERVICAL (FRONTAL, LATERAL Y OBLRadiografía de columna cervical (frontal, lateral y oblicuas) | $29.760 | $29.760 |
| 04-01-044-00 | 0401044 | COLUMNA CERVICAL FUNCIONAL ADICIONAL (2Radiografía de columna cervical flexión y extensión (Dinámicas) | $16.690 | $16.690 |
| 04-01-045-00 | 0401045 | COLUMNA DORSAL O DORSOLUMBAR LOCALIZADA,Radiografía de columna dorsal o dorsolumbar localizada, parrilla costal (frontal y lateral) | $20.590 | $20.590 |
| 04-01-046-00 | 0401046 | COLUMNA LUMBAR O LUMBOSACRA (AMBAS INCLURadiografía columna lumbar o lumbosacra ( frontal, lateral y focalizada en el 5° espacio) | $30.480 | $30.480 |
| 04-01-047-00 | 0401047 | COLUMNA LUMBAR O LUMBOSACRA FUNCIONAL (2Radiografía columna lumbar o lumbosacra flexión y extensión (Dinámicas) | $24.780 | $24.780 |
| 04-01-048-00 | 0401048 | COLUMNA LUMBAR O LUMBOSACRA, OBLICUAS ADRadiografía columna lumbar o lumbosacra, oblicuas adicionales | $16.690 | $16.690 |
| 04-01-049-00 | 0401049 | COLUMNA TOTAL O DORSOLUMBAR, PANORAMICARadiografía de columna total, panorámica con folio graduado frontal o lateral | $22.800 | $22.800 |
| 04-01-051-00 | 0401051 | PELVIS, CADERA O COXOFEMORAL,C/U (1 EXP.Radiografía de pelvis, cadera o coxofemoral | $13.550 | $13.550 |
| 04-01-052-00 | 0401052 | PELVIS, CADERA O COXOFEMORAL, PROYECCIONRadiografía de pelvis, cadera o coxofemoral, proyecciones especiales; (rotación interna, abducción, lateral, Lawenstein u otras) | $12.350 | $12.350 |
| 04-01-053-00 | 0401053 | SACROCOXIS O ARTICULACIONES SACROILIACASRadiografía de Sacrocoxis o articulaciones sacroilíacas. | $18.590 | $18.590 |
| 04-01-054-00 | 0401054 | BRAZO, ANTEBRAZO, CODO, MUNECA, MANORadiografía de brazo, antebrazo, codo, muñeca, mano, dedos, pie (frontal y lateral) | $15.420 | $15.420 |
| 04-01-055-00 | 0401055 | CLAVICULA (2 EXP.)Radiografía de clavícula. | $18.050 | $18.050 |
| 04-01-056-00 | 0401056 | EDAD OSEA : CARPO Y MANO (1 EXP.)Radiografía Edad Ósea: carpo y mano | $12.860 | $12.860 |
| 04-01-058-00 | 0401058 | ESTUDIO DE ESCAFOIDESEstudio radiológico de escafoides | $20.180 | $20.180 |
| 04-01-059-00 | 0401059 | ESTUDIO MUNECA O TOBILLO (FRONT.,LATERALEstudio radiológico de muñeca o tobillo frontal lateral y oblicuas | $17.440 | $17.440 |
| 04-01-060-00 | 0401060 | HOMBRO, FEMUR, RODILLA, PIERNA, COSTILLARadiografía de hombro, fémur, rodilla, pierna, costilla o esternón Frontal y Lateral | $18.240 | $18.240 |
| 04-01-060-01 | 0401060 | ESTERNON,HUMERO,PARRILLA COSTALRadiografía de hombro, fémur, rodilla, pierna, costilla o esternón Frontal y Lateral | $18.240 | $18.240 |
| 04-01-062-00 | 0401062 | PROYECCIONES ESPECIALES,AXIALESRadiografía de Proyecciones especiales oblicuas u otras en hombro, brazo, codo, rodilla, rótulas, sesamoideos, axial de ambas rótulas o similares | $12.690 | $12.690 |
| 04-01-063-00 | 0401063 | TUNEL INTERCONDILEO O RADIO-CARPIANORadiografía de túnel intercondíleo o radio-carpiano | $12.350 | $12.350 |
| 04-01-064-00 | 0401064 | APOYO FLUOROSCOPICO A PROCEDIMIENTOS INTApoyo fluoroscópico a procedimientos intraoperatorios y/o biopsia (no incluye el proc.) | $14.990 | $14.990 |
| 04-01-070-00 | 0401070 | TORAX (FRONTAL Y LATERAL) (INCLUYE FLUORRadiografía de tórax frontal y lateral | $31.890 | $31.890 |
| 04-01-071-00 | 0401071 | MAMOGRAFIA BILATERAL CON TOMOSINTESIS | $51.930 | $51.930 |
| 04-01-072-00 | 0401072 | MAMOGRAFIA UNILATERAL CON TOMOSINTESIS | $30.200 | $30.200 |
| 04-01-110-00 | 0401110 | MAMOGRAFIA UNILATERAL (2 EXP.)Mamografía unilateral | $22.080 | $22.080 |
| 04-01-130-00 | 0401130 | PROYECCION COMPLEMENTARIA DE MAMAS (AXILMamografía proyección complementaria (axilar u otras) | $8.060 | $8.060 |
| 04-01-151-00 | 0401151 | PELVIS, CADERA O COXOFEMORAL DE RN, LACTRadiografía de pelvis, cadera o coxofemoral de RN, lactante o niño menor de 6 años. | $12.930 | $12.930 |
| 04-02-005-00 | 0402005 | GALACTOGRAFIA, UN LADO (A.C. 20-01-012)Galactografía, unilateral | $19.230 | $19.230 |
| 04-02-008-00 | 0402008 | COLANGIOPANCREATOGRAFIA ENDOSCOPICA (A.CColangiopancreatografía endoscópica (a.c.18-01-018; 5-7 exp) | $50.560 | $50.560 |
| 04-02-009-00 | 0402009 | FISTULOGRAFIA (A.C. 18-01-020) (3 EXP.)Fistulografía (a.c. 18-01-020) (3 exp.) | $13.780 | $13.780 |
| 04-02-012-00 | 0402012 | PIELOGRAFIA ASCENDENTE (A.C. 19-01-015)Pielografía ascendente (a.c. 19-01-015) (3 exp.) | $44.980 | $44.980 |
| 04-02-015-00 | 0402015 | ARTROGRAFIA FACETARIAArtrografía facetaria | $62.130 | $62.130 |
| 04-02-019-00 | 0402019 | ANGIOGRAFIA SELECTIVA DE CAROTIDA EXTERNAngiografía selectiva de carótida externa o interna (a.c 17-01-061 al 17-01-069, según corresponda) | $69.580 | $69.580 |
| 04-02-020-00 | 0402020 | ANGIOGRAFIA SELECTIVA MEDULAR (A.C 17-01Angiografía selectiva medular (a.c 17-01-061 al 17-01-069, según corresponda) | $71.790 | $71.790 |
| 04-02-022-00 | 0402022 | ANGIOPLASTIA INTRALUMINAL CORONARIA. PROAngioplastia intraluminal coronaria. procedimiento radiológico. (a.c.17-01-031) | $112.830 | $112.830 |
| 04-02-023-00 | 0402023 | ANGIOPLASTIA INTRALUMINAL PERIFERICA. PRAngioplastia intraluminal periférica. procedimiento radiológico. (a.c. 17-01-032) | $78.590 | $78.590 |
| 04-02-023-01 | 0402023 | ANGIOPLASTIA VASOS DE CABEZA Y CUELLOAngioplastia intraluminal periférica. procedimiento radiológico. (a.c. 17-01-032) | $78.590 | $78.590 |
| 04-02-024-00 | 0402024 | AORTOGRAFIA CON AOT O CINEANGIOGRAFIA (AAortografía con AOT o cineangiografía (a.c. 17-01-022) | $82.380 | $82.380 |
| 04-02-025-00 | 0402025 | ARTERIOGRAFIA DE CADA EXTREMIDAD, (A.C.1Arteriografía de miembros superiores o inferiores unilateral (a.c.17-01-023) | $52.060 | $52.060 |
| 04-02-027-00 | 0402027 | ARTERIOGRAFIA SELECTIVA CON AOT O CINEANArteriografía selectiva con AOT o cineangiografía (pulmonar, renal, tronco celíaco o similar) c/u. (a.c 17-01-061 al 17-01-069, según corresponda) | $96.770 | $96.770 |
| 04-02-029-00 | 0402029 | ARTERIOGRAFIA CAROTIDA VERTEBRAL POR CATArteriografía de vasos del cuello ( carótidas y vertebrales) (a.c. 11-01-013) | $70.740 | $70.740 |
| 04-02-030-00 | 0402030 | CINECORONARIOGRAFIA (A.C. 17-01-019)Cinecoronariografía (a.c. 17-01-019) | $87.980 | $87.980 |
| 04-02-031-00 | 0402031 | EMBOLIZACION O BALONIZACION (A.C. DE LAEmbolización o balonización (a.c. de la angiografía correspondiente) (incluye control radiológico inmediato) | $55.230 | $55.230 |
| 04-02-032-00 | 0402032 | INSTALACION DE CATETER O SONDA INTRACARDInstalación de catéter o sonda intracardíaca, control por radiólogo de (a.c. 17-01-020, 17-01-021, 17-01-011 o 17-01-014, según corresponda) | $38.590 | $38.590 |
| 04-02-033-00 | 0402033 | VENTRICULOGRAFIA DERECHA Y/O IZQUIERDA (Ventriculografía derecha y/o izquierda (a.c. 17-01-011, 17-01-020 ó 17-01-021 ó 17-01-041 ó 17-01-42 ó 17-01-43, según corresponda) | $87.980 | $87.980 |
| 04-02-035-00 | 0402035 | CAVOGRAFIA (A.C. 17-01-025)Cavografía (a.c. 17-01-025) | $49.760 | $49.760 |
| 04-02-038-00 | 0402038 | FLEBOGRAFIA EXTREMIDAD INFERIOR O SUPERIFlebografía extremidad inferior o superior, unilateral (a.c. 17-01-026) cada extremidad. | $44.020 | $44.020 |
| 04-02-041-00 | 0402041 | FLEBOGRAFIA SELECTIVA (SUPRARRENAL Y SIMFlebografía selectiva de venas hepáticas, renales, gonadales, pélvicas. (a.c. 17-01-027) | $49.760 | $49.760 |
| 04-02-050-00 | 0402050 | MIELOGRAFIA POR PUNCION LUMBAR CON CONTRMielografía por punción lumbar con contraste hidrosoluble (a.c. 11-01-025) | $60.420 | $60.420 |
| 04-02-129-00 | 0402129 | ANGIOGRAFIA VASOESPASMO | $70.740 | $70.740 |
| 04-02-132-00 | 0402132 | IMAGEN INTRACORONARIA | $86.450 | $86.450 |
| 04-03-001-00 | 0403001 | CEREBRO (30 CORTES 8-10 MM.)Tomografía Computarizada de cráneo encefálica | $111.540 | $111.540 |
| 04-03-002-00 | 0403002 | SILLA TURCA (20 CORTES 2 MM)Tomografía Computarizada de hipotálamo-hipófisis | $117.380 | $117.380 |
| 04-03-003-00 | 0403003 | ANGULO PONTO CEREBELOSO (40 CORTES 2MM.)Tomografía Computarizada de fosa posterior | $100.820 | $100.820 |
| 04-03-006-00 | 0403006 | TEMPORAL-OIDO (INCLUYE CORONALES) (40 COTomografía Computarizada de temporal-oído | $96.800 | $96.800 |
| 04-03-007-00 | 0403007 | ORBITAS MAXILOFACIAL (INCLUYE CORONALES)Tomografía Computarizada de órbitas maxilofacial | $129.440 | $129.440 |
| 04-03-008-00 | 0403008 | COLUMNA CERVICAL (4 ESPACIOS - 5 VERTEBRTomografía Computarizada de columna cervical | $141.790 | $141.790 |
| 04-03-012-00 | 0403012 | CUELLO, PARTES BLANDAS (30 CORTES, 4-8 MTomografía Computarizada de cuello, partes blandas | $104.780 | $104.780 |
| 04-03-013-00 | 0403013 | TORAX TOTAL (30 CORTES 8-10 MM.)Tomografía Computarizada de Tórax. Incluye además: Esternón, Clavículas, Articulación Acromioclavicular, Escápula, Costillas, Articulación Esternoclavicular. Incluye todo el Tórax o cada segmento o articulación. Incluye bilateralidad | $165.500 | $165.500 |
| 04-03-014-00 | 0403014 | ABDOMEN (HIGADO, VIAS Y VESICULA BILIAR,Tomografía Computarizada de abdomen (hígado, vías y vesícula biliar, páncreas, bazo, suprarrenales y riñones) | $99.650 | $99.650 |
| 04-03-016-00 | 0403016 | PELVIS (28 CORTES, 8-10 MM.)Tomografía Computarizada de Pelvis (Además incluye Sacro, Coxis, Caderas, Huesos Pélvicos, Articulaciones Sacro Ilíacas). Bilateral | $102.190 | $102.190 |
| 04-03-017-00 | 0403017 | EXTREMIDADES, ESTUDIO LOCALIZADO (30 CORTomografía Computarizada Musculoesquelética por zona anatómica. Por cada segmento o articulación: muslo, pierna, rodillas, antebrazo, codo, muñeca, mano, hombro, pie, tobillo u otros. Bilateral sólo para rodillas | $89.220 | $89.220 |
| 04-03-018-00 | 0403018 | TOMOGRAFIA COMPUTARIZADA COLUMNA DORSALTomografía Computarizada de Columna Dorsal. Incluye mínimo 6 espacios | $124.240 | $124.240 |
| 04-03-019-00 | 0403019 | TOMOGRAFIA COMPUTARIZADA COLUMNA LUMBARTomografía Computarizada de Columna Lumbar | $124.240 | $124.240 |
| 04-03-020-00 | 0403020 | TAC ABDOMEN Y PELVISTomografía Computarizada de Abdomen y Pelvis | $162.640 | $162.640 |
| 04-03-022-00 | 0403022 | TAC UROGRAFIATomografía Computarizada Urografía | $95.680 | $95.680 |
| 04-03-025-00 | 0403025 | TOMOGRAFIA COMPUTARIZADA DE CALCIO CORONTomografía Computarizada de Calcio Coronario | $54.620 | $54.620 |
| 04-03-101-00 | 0403101 | ANGIOTAC DE CEREBROTomografía Computarizada angio de encéfalo | $135.180 | $135.180 |
| 04-03-102-00 | 0403102 | ANGIOTAC DE TORAXTomografía Computarizada angio de tórax | $203.520 | $203.520 |
| 04-03-103-00 | 0403103 | ANGIOTAC DE ABDOMENTomografía Computarizada angio de abdomen | $188.430 | $188.430 |
| 04-03-104-00 | 0403104 | ANGIO TC DE CUELLOTomografía Computarizada Angio de Cuello | $111.090 | $111.090 |
| 04-03-105-00 | 0403105 | TAC ANGIO DE PELVISTomografía Computarizada Angio de Pelvis | $81.010 | $81.010 |
| 04-03-106-00 | 0403106 | TAC ANGIO CARDIACOTomografía Computarizada de Angio Cardíaco. Mínimo 64 cortes | $106.190 | $106.190 |
| 04-03-106-01 | 0403106 | ANGIOTAC CORONARIATomografía Computarizada de Angio Cardíaco. Mínimo 64 cortes | $106.190 | $106.190 |
| 04-04-002-00 | 0404002 | ECOGRAFIA OBSTETRICAEcografía obstétrica | $13.970 | $13.970 |
| 04-04-003-00 | 0404003 | ECOTOMOGRAFIA ABDOMINAL (INCLUYE HIGADO,Ecografía abdominal (incluye hígado, vía biliar, vesícula, páncreas, riñones, bazo, retroperitoneo y grandes vasos) | $44.110 | $44.110 |
| 04-04-003-01 | 0404003 | ECO ABDOMINAL PEDIATRICAEcografía abdominal (incluye hígado, vía biliar, vesícula, páncreas, riñones, bazo, retroperitoneo y grandes vasos) | $44.110 | $44.110 |
| 04-04-004-00 | 0404004 | ECOTOMOGRAFIA COMO APOYO A CIRUGIA, O AEcografía como apoyo a cirugía, o a procedimiento (de tórax, muscular, partes blandas, etc.) | $27.260 | $27.260 |
| 04-04-005-00 | 0404005 | ECOTOMOGRAFIA TRANSVAGINAL O TRANSRECTALEcografía transvaginal o transrectal | $24.640 | $24.640 |
| 04-04-005-01 | 0404005 | ECOTOMOGRAFIA TRANSRECTALEcografía transvaginal o transrectal | $24.640 | $24.640 |
| 04-04-006-00 | 0404006 | ECOTOMOGRAFIA GINECOLOGICA, PELVIANA FEMEcografía ginecológica, pelviana femenina u obstétrica con estudio fetal | $23.470 | $23.470 |
| 04-04-006-01 | 0404006 | ECO GINECOLOGICA PEDIATRICAEcografía ginecológica, pelviana femenina u obstétrica con estudio fetal | $23.470 | $23.470 |
| 04-04-006-02 | 0404006 | ECOGRAFIA OBSTETRICA Y/O GINECOLOGICAEcografía ginecológica, pelviana femenina u obstétrica con estudio fetal | $23.470 | $23.470 |
| 04-04-007-00 | 0404007 | ECOTOMOGRAFIA TRANSVAGINAL PARA SEGUIMIEEcografía transvaginal para seguimiento de ovulación, procedimiento completo (6-8 sesiones ) | $34.260 | $34.260 |
| 04-04-008-00 | 0404008 | ECOTOMOGRAFIA PARA SEGUIMIENTO DE OVULACEcografía para seguimiento de ovulación, procedimiento completo (6 a 8 sesiones) | $38.370 | $38.370 |
| 04-04-009-00 | 0404009 | ECOTOMOGRAFIA PELVICA MASCULINA (INCLUYEEcografía pélvica masculina (incluye vejiga y próstata) | $24.530 | $24.530 |
| 04-04-010-00 | 0404010 | ECOTOMOGRAFIA RENAL (BILATERAL) Y DE BAZEcografía renal (bilateral), o de bazo | $30.580 | $30.580 |
| 04-04-011-00 | 0404011 | ECOTOMOGRAFIA CEREBRAL (R.N. O LACTANTE)Ecografía encefálica (RN o lactante) | $33.010 | $33.010 |
| 04-04-012-00 | 0404012 | ECOTOMOGRAFIA MAMARIA BILATERALEcografía mamaria bilateral (incluye Doppler) | $30.740 | $30.740 |
| 04-04-014-00 | 0404014 | ECOTOMOGRAFIA TESTICULAR (UNO O AMBOS)Ecografía testicular (unilateral o bilateral) (Incluye Doppler) | $30.340 | $30.340 |
| 04-04-015-00 | 0404015 | ECOTOMOGRAFIA TIROIDEAEcografía tiroidea (Incluye Doppler) | $30.740 | $30.740 |
| 04-04-016-00 | 0404016 | ECOGRAFIA PARTES BLANDAS O MUSCULOESQUELEcografía Partes Blandas o Musculoesquelética (cada zona anatómica) | $30.740 | $30.740 |
| 04-04-016-03 | 0404016 | ECO INGUINAL,TORAXICA,CERVICALEcografía Partes Blandas o Musculoesquelética (cada zona anatómica) | $30.740 | $30.740 |
| 04-04-016-04 | 0404016 | ECOGRAFIA CADERA NIÑOEcografía Partes Blandas o Musculoesquelética (cada zona anatómica) | $30.740 | $30.740 |
| 04-04-100-00 | 0404100 | ECOTOMOGRAFIA OBSTETRICA 3D | $61.970 | $61.970 |
| 04-04-101-00 | 0404101 | ECOTOMOGRAFIA GINECOLOGICA AMPLIADA | $60.000 | $60.000 |
| 04-04-118-00 | 0404118 | ECOTOMOGRAFIA VASCULAR (ART&VEN)PERF BIEcografía vascular (arterial y venosa) periférica (bilateral) | $100.860 | $100.860 |
| 04-04-118-01 | 0404118 | ECO DOPPLER VARICESEcografía vascular (arterial y venosa) periférica (bilateral) | $100.860 | $100.860 |
| 04-04-118-02 | 0404118 | ECO DOPPLER PENEEcografía vascular (arterial y venosa) periférica (bilateral) | $100.860 | $100.860 |
| 04-04-119-00 | 0404119 | ECO DOPPLER CAROTIDEA VERTEBRALEcografía doppler de vasos del cuello | $95.250 | $95.250 |
| 04-04-121-00 | 0404121 | ECOTOMOGRAFIA ABD O VASOS TESTICULARESEcografía abdominal o de vasos testiculares | $103.940 | $103.940 |
| 04-04-122-00 | 0404122 | ECOTOMOGRAFIA DOPPLER VASOS PLACENTARIOEcografía doppler de vasos placentarios | $100.860 | $100.860 |
| 04-05-001-00 | 0405001 | RM CRANEO-CEREBROResonancia Magnética Cráneo Encefálica u Oídos, bilateral | $215.350 | $215.350 |
| 04-05-001-01 | 0405001 | RM CRANEO-CEREBRO SIN CONTRASTEResonancia Magnética Cráneo Encefálica u Oídos, bilateral | $215.350 | $215.350 |
| 04-05-002-00 | 0405002 | RM HIPOTALAMO-HIPOFISISResonancia Magnética de hipotálamo - hipófisis | $224.230 | $224.230 |
| 04-05-003-00 | 0405003 | RM ORBITASResonancia Magnética de órbitas | $201.000 | $201.000 |
| 04-05-004-00 | 0405004 | RM ARTICULACIONES TEMPORO MAXILARResonancia Magnética de articulaciones temporomandibulares | $216.130 | $216.130 |
| 04-05-005-00 | 0405005 | RM COLUMNA CERVICALResonancia Magnética de columna cervical | $215.350 | $215.350 |
| 04-05-006-00 | 0405006 | RM COLUMNA DORSALResonancia Magnética de columna dorsal | $223.960 | $223.960 |
| 04-05-007-00 | 0405007 | RM COLUMNA LUMBARResonancia Magnética de columna lumbar | $215.350 | $215.350 |
| 04-05-009-00 | 0405009 | RM TORAXResonancia Magnética de Tórax ( corazón, esternón, clavículas, articulación acromioclavicular, escápula, costillas o articulación esternoclavicular). Toda la pared torácica o cada segmento o articulación. Bilateral | $230.760 | $230.760 |
| 04-05-010-00 | 0405010 | RM ABDOMEN TOTALResonancia Magnética de abdomen | $215.350 | $215.350 |
| 04-05-011-00 | 0405011 | RM PELVISResonancia Magnética de Pelvis. Incluye: osteoarticular de sacroiliacas u osteoarticular de sacrocoxis u osteoarticular de huesos pélvicos u órganos pelvianos (incluye genitales internos y gastrointestinal) | $215.350 | $215.350 |
| 04-05-012-00 | 0405012 | RM ABDOMEN + PELVISResonancia Magnética de abdomen y pelvis | $322.990 | $322.990 |
| 04-05-013-00 | 0405013 | RM RODILLA ESTUDIO POR RESONANCIA UNILATResonancia Magnética de rodilla | $176.560 | $176.560 |
| 04-05-016-00 | 0405016 | COLUMNA TOTAL ESTUDIO DE COLUMNA C-D-LResonancia Columna Total (cervical, dorsal, lumbar) | $381.050 | $381.050 |
| 04-05-017-00 | 0405017 | RM ANGIOGRAFIA DE ENCEFALOResonancia Magnética Angiografía de Encéfalo | $230.760 | $230.760 |
| 04-05-018-00 | 0405018 | RM ANGIOGRAFIA DE CUELLOResonancia Magnética Angiografía de Cuello | $237.300 | $237.300 |
| 04-05-019-00 | 0405019 | RM ANGIOGRAFIA DE TORAXResonancia Magnética Angiografía de Tórax | $233.510 | $233.510 |
| 04-05-020-00 | 0405020 | RM ANGIOGRAFIA DE ABDOMENResonancia Magnética Angiografía de Abdomen | $218.070 | $218.070 |
| 04-05-021-00 | 0405021 | RM ANGIOGRAFIA DE PELVISResonancia Magnética Angiografía de Pelvis | $224.230 | $224.230 |
| 04-05-022-00 | 0405022 | RM ANGIOGRAFIA DE EXTREMIDAD SUPERIOR UNResonancia Magnética Angiografía de Extremidad Superior Unilateral | $221.610 | $221.610 |
| 04-05-023-00 | 0405023 | RM ANGIOGRAFIA EXTREMIDAD INF BILATERALResonancia Magnética Angiografía de Extremidad Inferior Bilateral | $215.350 | $215.350 |
| 04-05-024-00 | 0405024 | RM MANO O MUÑECAResonancia Magnética de Mano o Muñeca | $189.210 | $189.210 |
| 04-05-025-00 | 0405025 | RM ANTEBRAZO O BRAZOResonancia Magnética de Antebrazo o Brazo | $180.930 | $180.930 |
| 04-05-026-00 | 0405026 | RM CODOResonancia Magnética de Codo | $183.850 | $183.850 |
| 04-05-027-00 | 0405027 | RM HOMBROResonancia Magnética de Hombro | $176.560 | $176.560 |
| 04-05-028-00 | 0405028 | RM PIE, ANTEPIE O TOBILLOResonancia Magnética de Pie, Antepie o Tobillo | $176.560 | $176.560 |
| 04-05-029-00 | 0405029 | RM PIERNAResonancia Magnética de Pierna | $181.710 | $181.710 |
| 04-05-030-00 | 0405030 | RM MUSLO O CADERA UNILATERALResonancia Magnética de Muslo o Cadera. Unilateral | $183.850 | $183.850 |
| 04-05-031-00 | 0405031 | RM DE MAMA BILATERALResonancia Magnética de Mama (bilateral) | $176.560 | $176.560 |
| 04-05-098-00 | 0405098 | COLANGIORESONANCIAColangioresonancia | $144.250 | $144.250 |
| 04-06-010-00 | 0406010 | PUNCION TIROIDES BAJO ECOGRAFIA | No disponible | $80.000 |
| 04-06-011-00 | 0406011 | PUNCION TIROIDES BAJO ECO X 2 | $120.000 | $120.000 |
| 04-06-012-00 | 0406012 | INSTALACION PICC | $300.000 | $300.000 |
| 04-06-013-00 | 0406013 | PUNCION LUMBAR SIMPLE | $80.000 | $80.000 |
| 04-06-101-00 | 0406101 | BIOPSIA PERCUTANEA CON TECNICA COAXIAL | $550.000 | $550.000 |
| 04-06-102-00 | 0406102 | NEFROSTOMIA PERCUTANEA SELDINGER UNILAT | $900.000 | $900.000 |
| 04-06-103-00 | 0406103 | NEFROSTOMIA PERCUTANEA SELDINGER BILATER | $900.000 | No disponible |
| 04-06-104-00 | 0406104 | DRENAJE BILIAR PERCUTANEO TEC SELDINGER | $900.000 | $900.000 |
| 04-06-105-00 | 0406105 | OTROS DRENAJES PERCUTANEOS | $550.000 | $550.000 |
| 04-06-106-00 | 0406106 | OTROS DRENAJES PERCUTANEOS CON TROCAR | $300.000 | $300.000 |
| 04-06-107-00 | 0406107 | PUNCION ASPIRATIVA CON AGUJA FINA | $255.000 | $255.000 |
| 04-06-108-00 | 0406108 | PLASTIA/INST PROTESIS BILIAR/URET PERCUT | $318.000 | $300.000 |
| 04-06-109-00 | 0406109 | GASTROTOMIA PERCUTANEA | $540.000 | $540.000 |
| 04-06-110-00 | 0406110 | ABLACION PERCUTANEADE TU POR RADIO FRECU | $318.000 | $300.000 |
| 04-06-111-00 | 0406111 | CAMBIO DRENAJE TECNICA SELDINGER | $150.000 | $150.000 |
| 04-06-112-00 | 0406112 | HONORARIOS EN INFILTRACIÓN | $70.000 | $70.000 |
| 04-06-113-00 | 0406113 | DRENAJE PERCUTANEO COMPLEJO | No disponible | $750.000 |
| 04-06-114-00 | 0406114 | PUNCION DIAGNOSTICA BAJO ECO Y TAC | $255.000 | $255.000 |
| 04-06-115-00 | 0406115 | INYECCION PERCUTANEA BAJO IMAGENES | $300.000 | $300.000 |
| 04-06-116-00 | 0406116 | BLOQUEO PLEXO BAJO IMAGEN | $700.000 | $700.000 |
| 04-06-117-00 | 0406117 | INSTALACION VIA VENOSA /ARTERIAL BAJO IM | $300.000 | $300.000 |
| Código CHP | Código Fonasa | Nombre prestación | Valor particular | Valor Fonasa |
|---|---|---|---|---|
| 03-01-003-00 | 0301003 | MIELOGRAMA EN HOSPITALIZACION | $13.580 | $13.580 |
| 03-01-003-01 | 0301004 | MIELOGRAMA C/U | $13.580 | $13.580 |
| 03-01-011-00 | 0301011 | COAGULACION, TIEMPO DE | $2.460 | $2.460 |
| 03-01-014-00 | 0301014 | PRUEBA DE ANTIGLOBULINA DIRECTA | $2.290 | $2.290 |
| 03-01-021-00 | 0301021 | FIBRINOGENO | $4.190 | $4.190 |
| 03-01-022-00 | 0301022 | TEST DE NEUTRALIZACION PLAQUETARIA | $8.240 | $8.240 |
| 03-01-026-00 | 0301026 | FERRITINA | $9.870 | $9.870 |
| 03-01-027-00 | 0301027 | FIBRINOGENO, PRODUCTOS DE DEGRADACION DE | $8.240 | $8.240 |
| 03-01-028-00 | 0301028 | FIERRO SERICO | $3.490 | $3.490 |
| 03-01-029-01 | 0301029 | CAPACIDAD DE FIJACION DEL FIERRO (INCLUY | $7.580 | $7.580 |
| 03-01-030-00 | 0301030 | FIERRO, CINETICA DEL (CADA DETERMINACION | $8.540 | $8.540 |
| 03-01-034-00 | 0301034 | GRUPOS SANGUINEOS AB0 Y RHO (INCLUYE EST | $4.100 | $4.100 |
| 03-01-036-00 | 0301036 | HEMATOCRITO (PROC. AUT.) | $1.260 | $1.260 |
| 03-01-036-01 | 0301036 | HEMATOCRITO EN LIQUIDOS | $1.260 | $1.260 |
| 03-01-038-00 | 0301038 | HEMOGLOBINA EN SANGRE TOTAL (PROC. AUT.) | $1.260 | $1.260 |
| 03-01-040-00 | 0301040 | HEMOGLOBINA FETAL CUANTITATIVA EN ERITRO | $7.970 | $7.970 |
| 03-01-041-00 | 0301041 | HEMOGLOBINA GLICADA | $7.420 | $7.420 |
| 03-01-044-00 | 0301044 | HEMOGLOBINA, ELECTROFORESIS DE (INCLUYE | $8.690 | $8.690 |
| 03-01-045-00 | 0301045 | HEMOGRAMA (INC. REC.DE LEUCOCITOS Y ERIT | $5.070 | $5.070 |
| 03-01-051-01 | 0301051 | ANTICUERPOS IRREGULARES, ISOINMUNIZACION | $8.240 | $8.240 |
| 03-01-059-00 | 0301059 | PROTOMBINA, TIEMPO DE O CONSUMO DE (INCL | $2.540 | $2.540 |
| 03-01-059-02 | 0301059 | TACO | $2.540 | $2.540 |
| 03-01-062-00 | 0301062 | RECUENTO DE BASOFILOS (ABSOLUTO) | $1.730 | $1.730 |
| 03-01-062-01 | 0301062 | BASOFILOS, RECUENTO ABSOLUTO DE | $1.730 | $1.730 |
| 03-01-063-01 | 0301063 | RECUENTO DE EOSINOFILOS ABSOLUTO | $1.620 | $1.620 |
| 03-01-064-00 | 0301064 | RECUENTO DE ERITROCITOS, ABSOLUTO (PROC. | $1.230 | $1.230 |
| 03-01-064-01 | 0301064 | ERITROCITOS, RECUENTO ABSOLUTO DE (PROC. | $1.230 | $1.230 |
| 03-01-065-00 | 0301065 | RECUENTO DE LEUCOCITOS, ABSOLUTO (PROC. | $1.200 | $1.200 |
| 03-01-066-00 | 0301066 | RECUENTO DE LINFOCITOS (ABSOLUTO) | $2.080 | $2.080 |
| 03-01-066-01 | 0301066 | LINFOCITOS, RECUENTO ABSOLUTO | $2.080 | $2.080 |
| 03-01-067-00 | 0301067 | RECUENTO DE PLAQUETAS (ABSOLUTO) | $2.130 | $2.130 |
| 03-01-068-00 | 0301068 | RECUENTO DE RETICULOCITOS (ABSOLUTO O PO | $1.650 | $1.650 |
| 03-01-069-00 | 0301069 | RECUENTO DIFERENCIAL O FORMULA LEUCOCITA | $3.490 | $3.490 |
| 03-01-072-01 | 0301072 | IVY, TIEMPO DE SANGRIA (NO INCLUYE DISPO | $2.460 | $2.460 |
| 03-01-082-00 | 0301082 | TRANSFERRINA | $9.020 | $9.020 |
| 03-01-085-00 | 0301085 | TROMBOPLASTINA, TIEMPO PARCIAL DE (TTPA, | $3.920 | $3.920 |
| 03-01-086-00 | 0301086 | VELOCIDAD DE ERITROSEDIMENTACION (PROC. | $910 | $910 |
| 03-01-086-01 | 0301086 | VHS, VELOCIDAD DE ERITROSEDIMENTACION (P | $910 | $910 |
| 03-01-095-00 | 0301095 | DIMERO D | $19.650 | $19.650 |
| 03-01-096-00 | 0301096 | PROCALCITONINA | $71.550 | $44.720 |
| 03-02-001-01 | 0302001 | CETONEMIA, ACETONA CUALITATIVA | $1.540 | $1.540 |
| 03-02-004-00 | 0302004 | ACIDO LACTICO | $6.690 | $6.690 |
| 03-02-005-00 | 0302005 | ACIDO URICO, EN SANGRE | $2.500 | $2.500 |
| 03-02-008-00 | 0302008 | AMILASA, EN SANGRE | $3.920 | $3.920 |
| 03-02-009-00 | 0302009 | MSUD SCREENING | $11.040 | $11.040 |
| 03-02-009-01 | 0302009 | MSUD NEONATAL | $11.040 | $11.040 |
| 03-02-011-00 | 0302011 | BICARBONATO (PROC.AUT.) | $1.180 | $1.180 |
| 03-02-012-00 | 0302012 | BILIRRUBINA TOTAL (PROC.AUT.) | $2.540 | $2.540 |
| 03-02-012-02 | 0302012 | BILIRRUBINA NEONATAL (TOTAL) | $2.540 | $2.540 |
| 03-02-013-00 | 0302013 | BILIRRUBINA TOTAL Y CONJUGADA | $2.400 | $2.400 |
| 03-02-013-02 | 0302013 | BILIRRUBINA NEONATAL | $2.400 | $2.400 |
| 03-02-015-00 | 0302015 | CALCIO EN SANGRE | $2.270 | $2.270 |
| 03-02-017-00 | 0302017 | CAROTENO | $3.630 | $3.630 |
| 03-02-018-00 | 0302018 | CAROTENO BASAL | $7.870 | $7.870 |
| 03-02-018-01 | 0302018 | PRUEBA DE SOBRECARGA DE CAROTENO, ADEMAS | $7.870 | $7.870 |
| 03-02-018-02 | 0302018 | CAROTENO POST CARGA | $7.870 | $7.870 |
| 03-02-023-00 | 0302023 | CREATININA EN SANGRE | $2.190 | $2.190 |
| 03-02-024-00 | 0302024 | CREATININA, DEPURACION DE (CLEARENCE) (P | $4.830 | $4.830 |
| 03-02-024-01 | 0302024 | CLEARENCE DE CREATININA (PROC.AUT.) | $4.830 | $4.830 |
| 03-02-025-00 | 0302025 | CREATINQUINASA CK - MB MIOCARDICA | $8.700 | $8.700 |
| 03-02-026-00 | 0302026 | CREATINQUINASA CK - TOTAL | $6.240 | $6.240 |
| 03-02-027-00 | 0302027 | TROPONINA | $18.640 | $18.640 |
| 03-02-030-00 | 0302030 | DESHIDROGENASA LACTICA TOTAL (LDH) | $3.920 | $3.920 |
| 03-02-032-01 | 0302032 | CLORO, Electrolitos plasmáticos | $2.110 | $2.110 |
| 03-02-032-02 | 0302032 | POTASIO, Electrolitos plasmáticos | $2.110 | $2.110 |
| 03-02-032-03 | 0302032 | SODIO, Electrolitos plasmáticos (sodio, | $2.110 | $2.110 |
| 03-02-033-00 | 0302033 | ENZIMA CONVERTIDORA DE ANGIOTENSINA I | $13.070 | $13.070 |
| 03-02-034-00 | 0302034 | PERFIL LIPIDICO (INCLUYE: COLESTEROL TOT | $10.210 | $10.210 |
| 03-02-035-01 | 0302035 | ACIDO VALPROICO NIVELES PLASMATICOS DE | $10.260 | $10.260 |
| 03-02-035-02 | 0302035 | PRIMIDONA NIVELES PLASMATICOS DE | $10.260 | $10.260 |
| 03-02-035-06 | 0302035 | CARBAMAZEPINA, NIVELES PLASMATICOS DE | $10.260 | $10.260 |
| 03-02-035-07 | 0302035 | DIGOXINA, NIVELES PLASMATICOS DE | $10.260 | $10.260 |
| 03-02-035-08 | 0302035 | FENITOINA, NIVELES PLASMATICOS DE | $10.260 | $10.260 |
| 03-02-035-16 | 0302035 | FENOBARBITAL, NIVELES PLASMATICOS DE | $10.260 | $10.260 |
| 03-02-035-17 | 0302035 | TEOFILINA NIVEL PLASMATICO | $10.260 | $10.260 |
| 03-02-036-00 | 0302036 | FENILALANINA, PKU | $4.260 | $4.260 |
| 03-02-036-01 | 0302036 | PKU NEONATAL | $4.260 | $4.260 |
| 03-02-040-00 | 0302040 | FOSFATASAS ALCALINAS TOTALES | $2.100 | $2.100 |
| 03-02-042-00 | 0302042 | FOSFORO (FOSFATOS) EN SANGRE | $3.010 | $3.010 |
| 03-02-045-00 | 0302045 | GAMMA GLUTAMILTRANSPEPTIDASA (GGT) | $3.680 | $3.680 |
| 03-02-046-00 | 0302046 | GASES Y EQUILIBRIO ACIDO BASE EN SANGRE | $6.430 | $6.430 |
| 03-02-046-01 | 0302046 | GASES EN SANGRE VENOSOS | $6.430 | $6.430 |
| 03-02-046-02 | 0302046 | GASES EN SANGRE ARTERIALES | $6.430 | $6.430 |
| 03-02-046-03 | 0302046 | GASES EN SANGRE REPOSO | $6.430 | $6.430 |
| 03-02-046-04 | 0302046 | GASES EN SANGRE EJERCICIO | $6.430 | $6.430 |
| 03-02-046-05 | 0302046 | GASES EN SANGRE CORDON UMBILICAL | $6.430 | $6.430 |
| 03-02-046-06 | 0302046 | GASES EN SANGRE MIXTOS | $6.430 | $6.430 |
| 03-02-046-07 | 0302046 | GASES EN SANGRE CAPILAR | $6.430 | $6.430 |
| 03-02-047-00 | 0302047 | GLUCOSA EN SANGRE | $2.050 | $2.050 |
| 03-02-047-01 | 0302047 | HEMOGLUCOTEST | $2.050 | $2.050 |
| 03-02-047-02 | 0302047 | GLUCOSA EN SANGRE BASAL | $2.050 | $2.050 |
| 03-02-047-03 | 0302047 | GLUCOSA EN SANGRE POST CARGA | $2.050 | $2.050 |
| 03-02-047-04 | 0302047 | GLUCOSA EN SANGRE POST PRANDIAL | $2.050 | $2.050 |
| 03-02-047-05 | 0302047 | GLUCOSA EN SANGRE POST ALMUERZO | $2.050 | $2.050 |
| 03-02-047-06 | 0302047 | GLUCOSA EN SANGRE POST DESAYUNO | $2.050 | $2.050 |
| 03-02-047-07 | 0302047 | GLUCOSA 60 MINUTOS | $2.050 | $2.050 |
| 03-02-047-08 | 0302047 | GLUCOSA 30 MINUTOS | $2.050 | $2.050 |
| 03-02-047-09 | 0302047 | HEMOGLUCOTEST EN SERVICIO DE URGENCIA | $2.050 | $2.050 |
| 03-02-047-10 | 0302047 | GLUCOSA 90 MINUTOS | $2.050 | $2.050 |
| 03-02-048-00 | 0302048 | GLUCOSA, PRUEBA DE TOLERANCIA A LA GLUCO | $9.540 | $9.540 |
| 03-02-048-01 | 0302048 | CURVA EXTENDIDA DE GLUCOSA | $9.540 | $9.540 |
| 03-02-048-02 | 0302048 | CURVA ESPECIAL DE GLUCOSA | $9.540 | $9.540 |
| 03-02-053-00 | 0302053 | LIPASA | $4.350 | $4.350 |
| 03-02-055-00 | 0302055 | LITIO | $4.780 | $4.780 |
| 03-02-056-00 | 0302056 | MAGNESIO | $5.230 | $5.230 |
| 03-02-057-00 | 0302057 | NITROGENO UREICO Y/O UREA, EN SANGRE | $2.160 | $2.160 |
| 03-02-061-01 | 0302061 | ELECTROFORESIS DE PROTEINAS, (INCLUYE CO | $10.320 | $10.320 |
| 03-02-063-01 | 0302063 | GOT(TRANSAMINASA OXALOACETICA) | $3.040 | $3.040 |
| 03-02-063-02 | 0302063 | GPT(TRANSAMINASA PIRUVICA) | $3.040 | $3.040 |
| 03-02-064-00 | 0302064 | TRIGLICERIDOS (PROC.AUT.) | $2.900 | $2.900 |
| 03-02-067-00 | 0302067 | COLESTEROL TOTAL (PROC.AUT.) | $2.220 | $2.220 |
| 03-02-068-00 | 0302068 | COLESTEROL HDL (PROC. AUT.) | $3.310 | $3.310 |
| 03-02-068-01 | 0302068 | HDL, COLESTEROL (PROC. AUT.) | $3.310 | $3.310 |
| 03-02-070-00 | 0302070 | APOLIPOPROTEINAS (A1) | $11.360 | $11.360 |
| 03-02-070-01 | 0302070 | APOLIPOPROTEINA B | $11.360 | $11.360 |
| 03-02-075-00 | 0302075 | PERFIL BIOQUIMICO (DETERMINACION AUTOMAT | $14.340 | $14.340 |
| 03-02-076-00 | 0302076 | PERFIL HEPATICO (INCL.TIEMPO DE PROTOMBI | $16.780 | $16.780 |
| 03-02-077-00 | 0302077 | VITAMINA B12 POR INMUNOENSAYO | $12.450 | $12.450 |
| 03-02-078-00 | 0302078 | VITAMINA D | $27.650 | $27.650 |
| 03-02-081-00 | 0302081 | CALCIO IONICO (INCLUYE MEDICION DE PH ME | $4.080 | $4.080 |
| 03-02-082-00 | 0302082 | FENILALANINA CUANTITATIVA EN GSS | $14.060 | $14.060 |
| 03-02-083-00 | 0302083 | CARBOXIHEMOGLOBINA | $38.050 | $23.780 |
| 03-02-100-00 | 0302100 | PROTEINAS TOTALES EN SANGRE | $2.420 | $2.420 |
| 03-02-101-00 | 0302101 | ALBUMINAS EN SANGRE | $2.420 | $2.420 |
| 03-03-001-00 | 0303001 | ADENOCORTICOTROFINA (ACTH) | $14.080 | $14.080 |
| 03-03-006-01 | 0303006 | CORTISOL BASAL | $9.170 | $9.170 |
| 03-03-006-02 | 0303006 | CORTISOL A.M. | $9.170 | $9.170 |
| 03-03-006-03 | 0303006 | CORTISOL P.M. | $9.170 | $9.170 |
| 03-03-007-00 | 0303007 | CRECIMIENTO, HORMONA DE (HGH) (SOMATOTRO | $11.620 | $11.620 |
| 03-03-007-02 | 0303007 | SOMATOTROFINA (HGH, HORMONA DEL CRECIMIE | $11.620 | $11.620 |
| 03-03-008-00 | 0303008 | DEHIDROEPIANDROSTERONA SULFATO (DHA, DHE | $11.440 | $11.440 |
| 03-03-014-00 | 0303014 | GONADOTROFINA CORIONICA, FRACCION BETA ( | $8.830 | $8.830 |
| 03-03-015-00 | 0303015 | HORMONA FOLICULO ESTIMULANTE (FSH) | $9.020 | $9.020 |
| 03-03-016-00 | 0303016 | HORMONA LUTEINIZANTE (LH) | $9.040 | $9.040 |
| 03-03-017-00 | 0303017 | INSULINA | $8.400 | $8.400 |
| 03-03-017-01 | 0303017 | INSULINA POST PRANDIAL | $8.400 | $8.400 |
| 03-03-018-00 | 0303018 | PARATHORMONA | $13.760 | $13.760 |
| 03-03-019-00 | 0303019 | PROGESTERONA | $8.540 | $8.540 |
| 03-03-020-00 | 0303020 | PROLACTINA (PRL) | $9.020 | $9.020 |
| 03-03-020-01 | 0303020 | PROLACTINA I | $9.020 | $9.020 |
| 03-03-022-00 | 0303022 | TESTOSTERONA EN SANGRE | $9.380 | $9.380 |
| 03-03-023-00 | 0303023 | TESTOSTERONA LIBRE EN SANGRE | $10.720 | $10.720 |
| 03-03-024-00 | 0303024 | TIROESTIMULANTE (TSH), HORMONA (ADULTO, | $7.420 | $7.420 |
| 03-03-024-01 | 0303024 | TSH NEONATAL | $7.420 | $7.420 |
| 03-03-025-00 | 0303025 | TIROGLOBULINA | $11.620 | $11.620 |
| 03-03-026-00 | 0303026 | TIROXINA LIBRE (T4L) | $8.540 | $8.540 |
| 03-03-027-00 | 0303027 | TIROXINA O TETRAYODOTIRONINA (T4) | $7.420 | $7.420 |
| 03-03-028-00 | 0303028 | TRIYODOTIRONINA (T3) | $7.710 | $7.710 |
| 03-03-029-00 | 0303029 | 17 - HIDROXIPROGESTERONA | $11.620 | $11.620 |
| 03-03-030-00 | 0303030 | ESTRADIOL (17-BETA) | $8.860 | $8.860 |
| 03-03-031-00 | 0303031 | INSULINA, CURVA DE (MIN.CUATRO DETERM. E | $22.660 | $22.660 |
| 03-03-035-00 | 0303035 | CORTISOL LIBRE URINARIO | $9.300 | $9.300 |
| 03-03-046-00 | 0303046 | SHBG (SEX-HORMONE BINDING GLOBULIN) | $20.800 | $20.800 |
| 03-03-123-00 | 0303123 | INDICE ANDROGENICO (INCLUYE TESTOSTERONA | $21.230 | $21.230 |
| 03-05-002-00 | 0305002 | ALFA -2- MACROGLOBULINA | $9.100 | $9.100 |
| 03-05-003-00 | 0305003 | ALFA FETOPROTEINAS | $8.540 | $8.540 |
| 03-05-004-02 | 0305004 | ENA, TAMIZAJE DE ANTICUERPOS NUCLEARES | $17.680 | $17.680 |
| 03-05-004-03 | 0305004 | SM, TAMIZAJE DE ANTICUERPOS NUCLEARES | $17.680 | $17.680 |
| 03-05-004-04 | 0305004 | RNP, TAMIZAJE DE ANTICUERPOS NUCLEARES | $17.680 | $17.680 |
| 03-05-004-05 | 0305004 | RO, TAMIZAJE DE ANTICUERPOS NUCLEARES | $17.680 | $17.680 |
| 03-05-004-06 | 0305004 | LA, TAMIZAJE DE ANTICUERPOS NUCLEARES | $17.680 | $17.680 |
| 03-05-004-07 | 0305004 | SCL-70, TAMIZAJE DE ANTICUERPOS NUCLEARE | $17.680 | $17.680 |
| 03-05-004-08 | 0305004 | JO-1, TAMIZAJE DE ANTICUERPOS NUCLEARES | $17.680 | $17.680 |
| 03-05-005-01 | 0305005 | ANTICUERPOS ANTINUCLEARES (ANA) | $12.450 | $12.450 |
| 03-05-005-02 | 0305005 | ANTICUERPOS ANTIMITOCONDRIALES | $12.450 | $12.450 |
| 03-05-005-03 | 0305005 | ANTICUERPOS ANTI DNA (ADNA) | $12.450 | $12.450 |
| 03-05-005-04 | 0305005 | ANTICUERPOS ANTI MUSCULO LISO | $12.450 | $12.450 |
| 03-05-005-05 | 0305005 | ANTICUERPOS ANTI CENTROMERO | $12.450 | $12.450 |
| 03-05-007-02 | 0305007 | ANTICUERPOS ANTIMICROSOMALES (ANTI TPO) | $9.940 | $9.940 |
| 03-05-007-03 | 0305007 | ANTICUERPOS ANTITIROGLOBULINAS (ANTICUER | $9.940 | $9.940 |
| 03-05-007-04 | 0305007 | ANTICUERPOS ANTI PROSTATICOS (ANTICUERPO | $9.940 | $9.940 |
| 03-05-008-00 | 0305008 | ANTIESTREPTOLISINA O, POR TECNICA DE LAT | $7.680 | $7.680 |
| 03-05-009-00 | 0305009 | ANTIGENO CARCINOEMBRIONARIO (CEA) | $11.620 | $11.620 |
| 03-05-010-00 | 0305010 | BETA-2-MICROGLOBULINA | $13.200 | $13.200 |
| 03-05-012-00 | 0305012 | COMPLEMENTO C1Q, C2, C3, C4, ETC., C/U | $7.680 | $7.680 |
| 03-05-012-03 | 0305012 | COMPLEMENTO C3 | $7.680 | $7.680 |
| 03-05-012-04 | 0305012 | COMPLEMENTO C4 | $7.680 | $7.680 |
| 03-05-013-00 | 0305013 | COMPLEMENTO HEMOLITICO (CH 50) | $12.350 | $12.350 |
| 03-05-013-01 | 0305013 | CH 50 (COMPLEMENTO HEMOLITICO) | $12.350 | $12.350 |
| 03-05-020-00 | 0305020 | FACTOR REUMATOIDEO POR TECNICA DE SCAT, | $7.550 | $7.550 |
| 03-05-021-01 | 0305021 | INHIBIDOR DE C1Q | $9.630 | $9.630 |
| 03-05-021-02 | 0305021 | INHIBIDOR DE C2 | $9.630 | $9.630 |
| 03-05-021-03 | 0305021 | INHIBIDOR DE C3 | $9.630 | $9.630 |
| 03-05-026-00 | 0305026 | INMUNOGLOBULINA IGA SECRETORA | $7.220 | $7.220 |
| 03-05-027-01 | 0305027 | INMUNOGLOBULINAS IGA | $8.450 | $8.450 |
| 03-05-027-02 | 0305027 | INMUNOGLOBULINAS IGG | $8.450 | $8.450 |
| 03-05-027-03 | 0305027 | INMUNOGLOBULINAS IGM | $8.450 | $8.450 |
| 03-05-028-01 | 0305028 | INMUNOGLOBULINAS IGE TOTAL | $8.820 | $8.820 |
| 03-05-028-02 | 0305028 | INMUNOGLOBULINAS IGD TOTAL | $8.820 | $8.820 |
| 03-05-029-01 | 0305029 | INMUNOGLOBULINAS IGE ESP. (CHOCOLATE) | $8.660 | $8.660 |
| 03-05-029-02 | 0305029 | INMUNOGLOBULINAS IGE ESP.(POLEN) | $8.660 | $8.660 |
| 03-05-029-03 | 0305029 | INMUNOGLOBULINAS IGE ESP. (PESCADO) | $8.660 | $8.660 |
| 03-05-029-04 | 0305029 | INMUNOGLOBULINAS IGE ESP. (LECHE DE VACA | $8.660 | $8.660 |
| 03-05-029-05 | 0305029 | INMUNOGLOBULINAS IGE ESP. (CASEINA) | $8.660 | $8.660 |
| 03-05-029-06 | 0305029 | INMUNOGL. IGE ESP. (CLARA DE HUEVO) | $8.660 | $8.660 |
| 03-05-029-07 | 0305029 | INMUNOGLOBULINAS IGE ESP. (PLATANO) | $8.660 | $8.660 |
| 03-05-029-08 | 0305029 | INMUNOGLOBULINAS IGE ESP. (MALEZAS | $8.660 | $8.660 |
| 03-05-029-09 | 0305029 | INMUNOGLOBULINAS IGE ESP. (PASTOS) | $8.660 | $8.660 |
| 03-05-029-10 | 0305029 | INMUNOGLOBULINA IGE ESP. (ARBOLES) | $8.660 | $8.660 |
| 03-05-029-11 | 0305029 | INMUNOGLOBULINAS IGE ESP. (POLVO) | $8.660 | $8.660 |
| 03-05-029-12 | 0305029 | INMUNOGL. IGE ESP. (CASPA DE PERRO) | $8.660 | $8.660 |
| 03-05-029-13 | 0305029 | INMUNOGL. IGE ESP. (CASPA DE GATO) | $8.660 | $8.660 |
| 03-05-029-14 | 0305029 | INMUNOGL. IGE ESP. (DERMATOF. PHARENCE) | $8.660 | $8.660 |
| 03-05-029-17 | 0305029 | IG E ESPECIFICA ALTERNARIA | $8.660 | $8.660 |
| 03-05-029-19 | 0305029 | IGE ESPECIFICA PLATANO ORIENTAL | $8.660 | $8.660 |
| 03-05-029-20 | 0305029 | INMUNOGLOBULINA E ESPECIFICA PARA HONGOS | $8.660 | $8.660 |
| 03-05-029-21 | 0305029 | IGE ESPECIFICA ALIMENTOS GRUPO 1 | $8.660 | $8.660 |
| 03-05-029-22 | 0305029 | IGE ESPECIFICA ALIMENTOS GRUPO 2 | $8.660 | $8.660 |
| 03-05-029-23 | 0305029 | IGE ESPECIFICA ALIMENTOS GRUPO 3 | $8.660 | $8.660 |
| 03-05-029-24 | 0305029 | IGE ESPECIFICA ALIMENTOS GRUPO 4 | $8.660 | $8.660 |
| 03-05-029-25 | 0305029 | IG E ESPECIFICA LATEX | $8.660 | $8.660 |
| 03-05-029-26 | 0305029 | INMUNOGLOBULINA E ESPECIFICA PARA PLUMAS | $8.660 | $8.660 |
| 03-05-029-30 | 0305029 | IGE ESPECIFICA PARA LATEX | $8.660 | $8.660 |
| 03-05-031-00 | 0305031 | PROTEINA C REACTIVA | $9.980 | $9.980 |
| 03-05-035-00 | 0305035 | CRIOAGLUTININAS | $4.370 | $4.370 |
| 03-05-036-00 | 0305036 | CRIOHEMOLISINAS | $4.370 | $4.370 |
| 03-05-070-00 | 0305070 | ANTIGENO PROSTATICO ESPECIFICO TOTAL | $14.940 | $14.940 |
| 03-05-070-01 | 0305070 | ANTIGENO PROSTATICO ESPECIFICO LIBRE | $14.940 | $14.940 |
| 03-05-081-01 | 0305081 | ANTICUERPO ANTIENDOMISIO | $18.620 | $18.620 |
| 03-05-082-02 | 0305082 | ANCA - C, ANTICUERPOS ANTICITOPLASMA DE | $26.640 | $26.640 |
| 03-05-082-04 | 0305082 | ANCA-P, ANTICUERPOS ANTICITOPLASMA DE NE | $26.640 | $26.640 |
| 03-05-084-01 | 0305084 | ANTICUERPOS ANTICARDIOLIPINAS (IGG) | $21.170 | $21.170 |
| 03-05-084-02 | 0305084 | ANTICUERPOS ANTICARDIOLIPINAS (IGM) | $21.170 | $21.170 |
| 03-05-086-01 | 0305086 | ANTICUERPOS ANTIGLIADINA IGG (ENFERMEDAD | $17.380 | $17.380 |
| 03-05-086-02 | 0305086 | ANTICUERPOS ANTIGLIADINA IGA | $17.380 | $17.380 |
| 03-05-091-00 | 0305091 | LINFOCITOS T(CD3,CD4,CD8,CITOMETRIA DE F | $47.890 | $47.890 |
| 03-05-092-00 | 0305092 | NATURAL KILLERS(CD16,CD56)CITOMETRIA DE | $46.640 | $46.640 |
| 03-05-099-00 | 0305099 | PEPTIDO CITRICO CITRULINADO | $62.130 | $38.830 |
| 03-05-104-00 | 0305104 | ANTIGENO PROSTATICO TOTAL Y LIBRE | $39.500 | $24.690 |
| 03-05-108-00 | 0305108 | ANTICUERPOS ANTI ANTIG NUCLEARES EXTRACT | $23.220 | $23.220 |
| 03-05-108-01 | 0305108 | ANTICUERPOS ENA (A-ENA),ANTI - SM | $23.220 | $23.220 |
| 03-05-108-02 | 0305108 | ANTICUERPOS ENA(A-ENA)ANTI-RNP | $23.220 | $23.220 |
| 03-05-108-03 | 0305108 | ANTICUERPOS ENA(A-ENA),ANTI-SS-A/RO | $23.220 | $23.220 |
| 03-05-108-04 | 0305108 | ANTICUERPOS ENA(A-ENA),ANTI-SS-B/LA | $23.220 | $23.220 |
| 03-05-108-05 | 0305108 | ANTICUERPOS ENA(A-ENA)ANTI-SCL-70 | $23.220 | $23.220 |
| 03-05-108-06 | 0305108 | ANTICUERPOS ENA (A-ENA)ANTI-JO-1 | $23.220 | $23.220 |
| 03-05-170-00 | 0305170 | ANTIGENO CA 125 | $15.490 | $15.490 |
| 03-05-170-01 | 0305170 | ANTIGENO CA 15-3 | $15.490 | $15.490 |
| 03-05-170-04 | 0305170 | ANTIGENO CA 19-9 | $15.490 | $15.490 |
| 03-06-001-00 | 0306001 | BACILOSCOPIA ZIEHL-NEELSEN POR CONCENTRA | $4.340 | $4.340 |
| 03-06-002-00 | 0306002 | BACILOSCOPIA ZIEHL-NEELSEN, C/U | $2.830 | $2.830 |
| 03-06-002-01 | 0306002 | BACILOSCOPIA I | $2.830 | $2.830 |
| 03-06-002-02 | 0306002 | BACILOSCOPIA II | $2.830 | $2.830 |
| 03-06-002-03 | 0306002 | BACILOSCOPIA III | $2.830 | $2.830 |
| 03-06-004-01 | 0306004 | EXAMEN DIRECTO AL FRESCO MICOLOGICO | $2.460 | $2.460 |
| 03-06-004-02 | 0306004 | EXAMEN DIRECTO AL FRESCO DEPOSICIONES | $2.460 | $2.460 |
| 03-06-005-00 | 0306005 | TINCION DE GRAM | $1.140 | $1.140 |
| 03-06-005-01 | 0306005 | GRAM, TINCION DE | $1.140 | $1.140 |
| 03-06-005-02 | 0306005 | TINCION DE GRAM EN HEMOCULTIVOS | $1.140 | $1.140 |
| 03-06-007-00 | 0306007 | COPROCULTIVO, C/U | $6.820 | $6.820 |
| 03-06-008-00 | 0306008 | CULTIVO CORRIENTE (EXCEPTO COPROCULTIVO, | $5.950 | $5.950 |
| 03-06-008-02 | 0306008 | CULTIVO ENTEROCOCO RESISTENTE A VANCOMI | $5.950 | $5.950 |
| 03-06-008-03 | 0306008 | DETECCION DE CARBAPENEMASAS | $5.950 | $5.950 |
| 03-06-008-07 | 0306008 | CAET CULTIVO | $5.950 | $5.950 |
| 03-06-011-00 | 0306011 | UROCULTIVO, RECUENTO COLONIAS Y ANTIBIOG | $6.080 | $6.080 |
| 03-06-012-00 | 0306012 | CULTIVO PARA ANAEROBIOS (INCLUYE COD. 03 | $14.540 | $14.540 |
| 03-06-014-00 | 0306014 | CULTIVO PARA CAMPYLOBACTER, YERSINIA, VI | $8.720 | $8.720 |
| 03-06-014-02 | 0306014 | CULTIVO PARA YERSINIA | $8.720 | $8.720 |
| 03-06-014-03 | 0306014 | CULTIVO PARA VIBRIO | $8.720 | $8.720 |
| 03-06-016-00 | 0306016 | NEISSERIA GONORRHOEAE (GONOCOCO) | $4.860 | $4.860 |
| 03-06-016-01 | 0306016 | GONOCOCO (NEISSERIA GONORRHOEAE), CULTIV | $4.860 | $4.860 |
| 03-06-017-00 | 0306017 | CULTIVO PARA HONGOS(LEVADURAS-FILAMENT) | $4.420 | $4.420 |
| 03-06-018-00 | 0306018 | CULTIVO PARA KOCH, BACILO DE | $7.520 | $7.520 |
| 03-06-018-01 | 0306018 | BACILO DE KOCH, CULTIVO | $7.520 | $7.520 |
| 03-06-022-00 | 0306022 | CULTIVO DE MYCOBACTERIA, TIPIFICACION DE | $10.130 | $10.130 |
| 03-06-022-01 | 0306022 | MYCOBACTERIA, CULTIVO DE (TIPIFICACION D | $10.130 | $10.130 |
| 03-06-025-01 | 0306025 | ANTIBIOGRAMA BACILO DE KOCH (CADA FARMAC | $8.640 | $8.640 |
| 03-06-026-00 | 0306026 | ANTIBIOGRAMA CORRIENTE (MINIMO 10 FARMAC | $4.420 | $4.420 |
| 03-06-027-00 | 0306027 | ANTIBIOGRAMA AUTOMATIZADO | $13.280 | $13.280 |
| 03-06-028-00 | 0306028 | ANTIFUNGIGRAMA (MINIMO 4 FARMACOS ANTIHO | $4.450 | $4.450 |
| 03-06-033-00 | 0306033 | BRUCELLA, REACCION DE AGLUTINACION PARA | $3.410 | $3.410 |
| 03-06-034-00 | 0306034 | CLAMIDIAS POR INMUNOFLUORESCENCIA, PEROX | $8.910 | $8.910 |
| 03-06-036-00 | 0306036 | MONONUCLEOSIS, REACCION DE PAUL BUNNELL, | $3.920 | $3.920 |
| 03-06-038-00 | 0306038 | R.P.R. | $4.430 | $4.430 |
| 03-06-039-00 | 0306039 | REACCION DE WIDAL | $5.820 | $5.820 |
| 03-06-041-01 | 0306041 | FTA-ABS (TREPONEMA PALLIDUM) | $8.180 | $8.180 |
| 03-06-042-00 | 0306042 | V.D.R.L. | $5.090 | $5.090 |
| 03-06-043-00 | 0306043 | ARTROPODOS MACROSCOPICOS (IMAGOS Y/O PUP | $5.230 | $5.230 |
| 03-06-045-01 | 0306045 | PARASITOLOGICO PARA CRYPTOSPORODIUM SP | $14.580 | $14.580 |
| 03-06-046-00 | 0306046 | COPROPARASITARIO SERIADO PARA FASCIOLA H | $33.220 | $33.220 |
| 03-06-048-00 | 0306048 | COPROPARASITOLOGICO SERIADO SIMPLE (INCL | $4.880 | $4.880 |
| 03-06-048-01 | 0306048 | PARASITOLOGICO SERIADO SIMPLE (TELEMANN | $4.880 | $4.880 |
| 03-06-051-00 | 0306051 | GRAHAM, EXAMEN DE (INCLUYE DIAGNOSTICO D | $3.460 | $3.460 |
| 03-06-052-00 | 0306052 | GUSANOS MACROSCOPICOS, DIAGNOSTICO DE (P | $2.880 | $2.880 |
| 03-06-053-00 | 0306053 | HEMOPARASITOS, DIAGNOSTICO MICROSCOPICO | $16.350 | $16.350 |
| 03-06-056-01 | 0306056 | ACAROTEST | $6.530 | $6.530 |
| 03-06-059-01 | 0306059 | COPROPARASITOLOGICO SERIADO (PAFS) | $6.500 | $6.500 |
| 03-06-061-01 | 0306061 | ELISA INDIRECTA CHAGAS | $9.220 | $9.220 |
| 03-06-061-02 | 0306061 | TOXOPLASMOSIS SEROLOGIA | $9.220 | $9.220 |
| 03-06-061-03 | 0306061 | ELISA INDIRECTA TOXOCARIASIS | $9.220 | $9.220 |
| 03-06-061-04 | 0306061 | CISTICERCOSIS SEROLOGIA | $9.220 | $9.220 |
| 03-06-069-03 | 0306069 | CITOMEGALOVIRUS, ANTICUERPOS IgG | $10.240 | $10.240 |
| 03-06-069-04 | 0306069 | CITOMEGALOVIRUS, ANTICUERPO IgM | $10.240 | $10.240 |
| 03-06-069-05 | 0306069 | HERPES SIMPLE, ANTICUERPOS VIRALES IgM | $10.240 | $10.240 |
| 03-06-069-06 | 0306069 | HERPES SIMPLE, ANTICUERPOS VIRALES IgG | $10.240 | $10.240 |
| 03-06-069-07 | 0306069 | RUBEOLA, ANTICUERPOS VIRALES IgM | $10.240 | $10.240 |
| 03-06-069-08 | 0306069 | RUBEOLA, ANTICUERPOS VIRALES IgG | $10.240 | $10.240 |
| 03-06-069-13 | 0306069 | EPSTEIN BARR, ANTICUERPOS VIRALES IgG e | $10.240 | $10.240 |
| 03-06-069-15 | 0306069 | VIRUS SINCICIAL RESPIRATORIO, ANTICUERPO | $10.240 | $10.240 |
| 03-06-069-16 | 0306069 | VRS ,ANTICUERPOS IGG | $10.240 | $10.240 |
| 03-06-069-17 | 0306069 | PARAINFLUENZA 1, ANTICUERPOS VIRALES Ig | $10.240 | $10.240 |
| 03-06-069-19 | 0306069 | PARAINFLUENZA 2, ANTICUERPOS VIRALES I | $10.240 | $10.240 |
| 03-06-069-21 | 0306069 | PARAINFLUENZA 3, ANTICUERPOS VIRALES Ig | $10.240 | $10.240 |
| 03-06-069-23 | 0306069 | COVID -19 IGG/IGM | $10.240 | $10.240 |
| 03-06-069-24 | 0306069 | ANTICUERPOS HTLV I Y II | $10.240 | $10.240 |
| 03-06-070-01 | 0306070 | ADENOVIRUS, ANTIGENOS VIRALES IFI | $9.170 | $9.170 |
| 03-06-070-03 | 0306070 | ADENOVIRUS EN DEPOSICION TEST RAPIDO | $9.170 | $9.170 |
| 03-06-070-05 | 0306070 | INFLUENZA A, ANTIGENOS VIRALES | $9.170 | $9.170 |
| 03-06-070-06 | 0306070 | INFLUENZA B, ANTIGENOS VIRALES | $9.170 | $9.170 |
| 03-06-070-07 | 0306070 | PARAINFLUENZA 1,ANTIGENOS VIRALES | $9.170 | $9.170 |
| 03-06-070-08 | 0306070 | PARAINFLUENZA 2 ANTIGENOS VIRALES | $9.170 | $9.170 |
| 03-06-070-09 | 0306070 | PARAINFLUENZA 3 ANTIGENOS VIRALES | $9.170 | $9.170 |
| 03-06-070-10 | 0306070 | VRS IFI | $9.170 | $9.170 |
| 03-06-074-00 | 0306074 | VIRUS HEPATITIS A, ANTICUERPOS IGM DEL | $12.580 | $12.580 |
| 03-06-076-00 | 0306076 | VIRUS HEPATITIS B, ANTICORE TOTAL DEL (A | $12.590 | $12.590 |
| 03-06-079-00 | 0306079 | VIRUS HEPATITIS B,ANTIGENO DE SUPERFICIE | $8.990 | $8.990 |
| 03-06-080-00 | 0306080 | VIRUS HEPATITIS B, ANTICORE IGM DEL (ANT | $12.530 | $12.530 |
| 03-06-081-00 | 0306081 | VIRUS HEPATITIS C, ANTICUERPOS DE (ANTI | $13.730 | $13.730 |
| 03-06-082-00 | 0306082 | REACCION DE POLIMERASA EN CADENA PCR | $40.960 | $25.600 |
| 03-06-090-01 | 0306090 | TEST PACK STREPTOCOCCUS. GRUPO A | $9.980 | $9.980 |
| 03-06-091-00 | 0306091 | HEMOCULTIVO AEROBICO PERIFERICO I | $29.010 | $29.010 |
| 03-06-091-01 | 0306091 | HEMOCULTIVO AEROBICO PERIFERICO II | $29.010 | $29.010 |
| 03-06-091-02 | 0306091 | HEMOCULTIVO AEROBICO CVC | $29.010 | $29.010 |
| 03-06-091-03 | 0306091 | HEMOCULTIVO ANAEROBICO I | $29.010 | $29.010 |
| 03-06-091-04 | 0306091 | HEMOCULTIVO ANAEROBICO II | $29.010 | $29.010 |
| 03-06-091-05 | 0306091 | HEMOCULTIVO ANAEROBICO CVC | $29.010 | $29.010 |
| 03-06-093-00 | 0306093 | HEMOCULTIVO AUTOMATIZADO PARA MICOBACTER | $30.580 | $30.580 |
| 03-06-097-00 | 0306097 | PCR CHLAMYDIA TRACHOMATIS/NEISSERA GONOR | $69.550 | $43.470 |
| 03-06-098-00 | 0306098 | TEST RAPIDO CLOSTRIDIUM DIFFICILE | $31.790 | $19.870 |
| 03-06-099-00 | 0306099 | STREPTOCOCCUS GRUPO B/AGALACTIAE EMBARAZ | $25.310 | $15.820 |
| 03-06-101-00 | 0306101 | CULTIVO AUTOMATIZADO LIQUIDOS | $35.460 | $22.160 |
| 03-06-111-00 | 0306111 | HTLV I -II DETERMINACION DE AC VIRALES | $126.260 | $78.910 |
| 03-06-112-00 | 0306112 | VIH ANTICUERPOS Y ANTG VIRALES HIV | $11.890 | $7.430 |
| 03-06-117-00 | 0306117 | CULTIVO PARA DERMATOFITOS | $4.990 | $4.990 |
| 03-06-118-00 | 0306118 | AMPLIFICACION DNA BORDETELLA | $104.350 | $65.220 |
| 03-06-120-00 | 0306120 | PCR PANEL GASTROINTESTINAL | $128.020 | $128.020 |
| 03-06-122-00 | 0306122 | PANEL VIRUS RESPIRATORIO MOLECULAR | $88.000 | $88.000 |
| 03-06-123-00 | 0306123 | VPH POR PCR GENOTIPIFICACION | $45.020 | $45.020 |
| 03-06-169-01 | 0306169 | HIV, ANTICUERPOS VIRALES | $8.880 | $8.880 |
| 03-06-170-01 | 0306170 | ROTAVIRUS, ANTIGENOS VIRALES | $8.400 | $8.400 |
| 03-06-270-00 | 0306270 | ANTIGENOS VIRALES DETERM. DE VIRUS SINCI | $9.700 | $9.700 |
| 03-06-270-01 | 0306270 | VIRUS SINCICIAL, ANTIGENOS VIRALES | $9.700 | $9.700 |
| 03-07-009-00 | 0307009 | ARTERIAL EN ADULTOS | $1.980 | $1.980 |
| 03-07-009-01 | 0307009 | TOMA MUESTRA ARTERIAL AD EN URGENCIAS | $1.980 | $1.980 |
| 03-07-010-00 | 0307010 | ARTERIAL EN NINOS Y LACTANTES | $2.930 | $2.930 |
| 03-07-010-01 | 0307010 | TOMA MUESTRA ARTERIAL NIÑOS EN URGENCIAS | $2.930 | $2.930 |
| 03-07-011-00 | 0307011 | VENOSA EN ADULTOS | $1.460 | $1.460 |
| 03-07-011-01 | 0307011 | VENOSA EN ADULTOS SERVICIO DE URGENCIA | $1.460 | $1.460 |
| 03-07-012-00 | 0307012 | VENOSA EN NINOS Y LACTANTES | $1.330 | $1.330 |
| 03-07-012-01 | 0307012 | VENOSA EN NIÑOS Y LACTANTES URGENCIAS | $1.330 | $1.330 |
| 03-07-013-00 | 0307013 | CON TECNICA ASEPTICA PARA HEMOCULTIVO, C | $2.290 | $2.290 |
| 03-07-014-00 | 0307014 | CAPILAR ( ADULTOS, NINOS Y LACTANTES ) | $1.360 | $1.360 |
| 03-07-016-00 | 0307016 | PUNCION TRAQUEAL | $3.970 | $3.970 |
| 03-07-018-00 | 0307018 | PUNCION MEDULAR OSEA | $23.120 | $23.120 |
| 03-07-023-00 | 0307023 | ASPIRADOS NASOFARINGEO PARA ADULTO Y NIÑ | $4.060 | $4.060 |
| 03-07-023-01 | 0307023 | TOMA MUESTRA ASPIRADO NASOFARINGEO URGE | $4.060 | $4.060 |
| 03-07-024-00 | 0307024 | REACCION CUTANEA A ALERGENOS (INCLUYE VA | $12.020 | $12.020 |
| 03-08-001-00 | 0308001 | AZUCARES REDUCTORES (BENEDICT-FEHLING O | $1.870 | $1.870 |
| 03-08-004-01 | 0308004 | HEMORRAGIAS OCULTAS I | $1.940 | $1.940 |
| 03-08-004-03 | 0308004 | HEMORRAGIAS OCULTAS II | $1.940 | $1.940 |
| 03-08-004-05 | 0308004 | HEMORRAGIAS OCULTAS III | $1.940 | $1.940 |
| 03-08-005-00 | 0308005 | LEUCOCITOS FECALES | $1.940 | $1.940 |
| 03-08-006-00 | 0308006 | PH EN DEPOSICIONES | $1.070 | $1.070 |
| 03-08-007-00 | 0308007 | ELASTASA FECAL | $126.130 | $78.830 |
| 03-08-010-02 | 0308010 | CITOQUIMICO LIQUIDO ARTICULAR | $5.490 | $5.490 |
| 03-08-010-03 | 0308010 | CITOQUIMICO LIQUIDO PERITONEAL | $5.490 | $5.490 |
| 03-08-010-04 | 0308010 | CITOLOGICO SECRECION BRONQUIAL | $5.490 | $5.490 |
| 03-08-010-05 | 0308010 | CITOQUIMICO LIQUIDO SINOVIAL | $5.490 | $5.490 |
| 03-08-010-06 | 0308010 | CITOQUIMICO LIQUIDO PLEURAL | $5.490 | $5.490 |
| 03-08-011-01 | 0308011 | TINCION TINTA CHINA | $2.540 | $2.540 |
| 03-08-011-02 | 0308011 | POLIFORMOS NUCLEARES EN CONT GASTRICO | $2.540 | $2.540 |
| 03-08-013-01 | 0308013 | EOSINOFILOS NASALES, RECUENTO DE | $1.330 | $1.330 |
| 03-08-013-02 | 0308013 | EOSINOFILOS BRONQUIALES, RECUENTO DE | $1.330 | $1.330 |
| 03-08-014-01 | 0308014 | CITOQUIMICO LIQUIDO CEFALO-RAQUIDEO (IN | $4.610 | $4.610 |
| 03-08-015-00 | 0308015 | GLUCOSA EN EXUDADOS, SECRECIONES Y OTROS | $1.200 | $1.200 |
| 03-08-017-00 | 0308017 | PH, EN LIQUIDOS (PROC. AUT.) | $1.150 | $1.150 |
| 03-08-022-00 | 0308022 | INDICE IGG/ALBUMINA (INCLUYE DETERM. DE | $23.790 | $23.790 |
| 03-08-033-00 | 0308033 | CELULAS ANARANJADAS (PROC. AUT.) | $1.310 | $1.310 |
| 03-08-044-00 | 0308044 | FLUJO VAGINAL O SECRECION URETRAL, ESTUD | $12.780 | $12.780 |
| 03-08-044-01 | 0308044 | FLUJO URETRAL (SECRECION) | $12.780 | $12.780 |
| 03-08-045-00 | 0308045 | AMILASA EN EXUDADOS SECRECIONES Y OTROS | $7.710 | $7.710 |
| 03-08-046-00 | 0308046 | LIPASA EN EXUDADOS SECRECIONES Y OTROS L | $5.090 | $5.090 |
| 03-08-062-00 | 0308062 | SANGRE OCULTA EN DEPOSICIONES ANALISIS I | $23.150 | $14.470 |
| 03-09-004-00 | 0309004 | ACIDO URICO EN ORINA (CUANTITATIV | $3.630 | $3.630 |
| 03-09-004-01 | 0309004 | URICOSURIA (ACIDO URICO O UREA EN ORINA) | $3.630 | $3.630 |
| 03-09-004-02 | 0309004 | ACIDO URICO ORINA 24 HORAS | $3.630 | $3.630 |
| 03-09-006-00 | 0309006 | AMILASA CUANTITATIVA EN ORINA | $4.450 | $4.450 |
| 03-09-006-02 | 0309006 | AMILASA ORINA 24 HORAS | $4.450 | $4.450 |
| 03-09-008-00 | 0309008 | CALCIO CUANTITATIVO EN ORINA | $3.360 | $3.360 |
| 03-09-008-02 | 0309008 | CALCIO ORINA 24 HORAS | $3.360 | $3.360 |
| 03-09-010-00 | 0309010 | CREATININA CUANTITATIVA EN ORINA | $2.540 | $2.540 |
| 03-09-010-01 | 0309010 | CREATININA ORINA 24 HORAS | $2.540 | $2.540 |
| 03-09-012-01 | 0309012 | SODIO EN ORINA | $2.590 | $2.590 |
| 03-09-012-02 | 0309012 | SODIO EN ORINA 24 HORAS | $2.590 | $2.590 |
| 03-09-012-03 | 0309012 | POTASIO EN ORINA | $2.590 | $2.590 |
| 03-09-012-04 | 0309012 | POTASIO ORINA 24 HORAS | $2.590 | $2.590 |
| 03-09-012-05 | 0309012 | CLORO EN ORINA | $2.590 | $2.590 |
| 03-09-013-00 | 0309013 | MICROALBUMINURIA | $4.660 | $4.660 |
| 03-09-013-01 | 0309013 | MICROALBUMINURIA 24 HORAS | $4.660 | $4.660 |
| 03-09-015-00 | 0309015 | FOSFORO CUANTITATIVO EN ORINA | $3.360 | $3.360 |
| 03-09-015-02 | 0309015 | FOSFORO ORINA 24 HORAS | $3.360 | $3.360 |
| 03-09-016-00 | 0309016 | GLUCOSA (CUANTITATIVO), EN ORINA | $2.290 | $2.290 |
| 03-09-016-02 | 0309016 | GLUCOSA ORINA 24 HORAS | $2.290 | $2.290 |
| 03-09-020-00 | 0309020 | NITROGENO UREICO O UREA EN ORINA (CUANTI | $1.410 | $1.410 |
| 03-09-020-01 | 0309020 | UREA EN ORINA (CUANTITATIVO) | $1.410 | $1.410 |
| 03-09-020-02 | 0309020 | NITROGENO UREICO ORINA 24 HORAS | $1.410 | $1.410 |
| 03-09-022-00 | 0309022 | ORINA COMPLETA, (INCLUYE COD. 03-09-023 | $3.140 | $3.140 |
| 03-09-024-01 | 0309024 | SEDIMENTO DE ORINA | $1.810 | $1.810 |
| 03-09-028-00 | 0309028 | PROTEINURIA MUESTRA AISLADA | $2.930 | $2.930 |
| 03-09-028-02 | 0309028 | PROTEINURIA 24 HORAS | $2.930 | $2.930 |
| 03-09-029-00 | 0309029 | PROTEINAS DE BENCE-JONES PRUEBA TERMICA | $1.890 | $1.890 |
| 33-01-002-00 | — | ACIDO FOLICO O FOLATOS | $22.928 | $22.928 |
| 33-01-002-01 | — | ACIDO FOLICO ERITROCITARIO | $22.928 | No disponible |
| 33-01-007-00 | — | ESTUDIO ANTICOAGULANTE LUPICO | $180.450 | $180.450 |
| 33-01-008-00 | — | ANTITROMBINA III | $58.263 | $58.263 |
| 33-01-017-00 | — | DESHIDROGENASA GLUCOSA-6-FOSFATO EN ERIT | $32.327 | $32.327 |
| 33-01-035-00 | — | HAPTOGLOBINA CUANTITATIVA | $56.126 | $56.126 |
| 33-01-043-01 | — | METAHEMOGLOBINA | $42.500 | $42.500 |
| 33-01-044-00 | — | HEMOGLOBINA, ELECTROFORESIS DE (INCLUYE | $33.977 | $8.690 |
| 33-01-055-00 | — | METALOPROTEINASA | $170.500 | $170.500 |
| 33-01-061-00 | — | (TR)-PCR TRANSLOCAC MUTACIO LEUCEMIA | $258.540 | $258.540 |
| 33-01-070-00 | — | RESISTENCIA GLOBULAR OSMOTICA | $13.910 | $13.910 |
| 33-01-091-00 | — | Proteina C (antigenica y funcional ). | $95.719 | $95.719 |
| 33-01-092-00 | — | PROTEINA S | $137.400 | $137.400 |
| 33-01-093-00 | — | RESISTENCIA PROTEINA C | $133.300 | $133.300 |
| 33-01-103-00 | — | AC. ANTIPLAQUETARIOS | $78.000 | $78.000 |
| 33-01-200-00 | — | ESTUDIO DE TROMBOFILIA | $1.021.650 | $1.021.650 |
| 33-01-201-00 | — | RESISTENCIA CLOPIDOGREL | $67.600 | No disponible |
| 33-02-009-03 | — | SCREENING NEONATAL AMPLIADO | $59.500 | No disponible |
| 33-02-009-04 | — | DETERMINACION DE AMINOACIDO EN LCR | $86.000 | No disponible |
| 33-02-016-00 | — | CALCIO IONICO, INCLUYE PROTEINAS TOTALES | $4.900 | $4.900 |
| 33-02-019-00 | — | CERULOPLASMINA | $5.520 | $5.520 |
| 33-02-020-00 | — | COBRE | $46.500 | $46.500 |
| 33-02-035-08 | — | NIVELES PLASMATICOS DE LEVETIRACETAM | $49.000 | No disponible |
| 33-02-035-09 | — | LACOSAMIDA NIVEL PLASMATICO | $61.709 | $61.709 |
| 33-02-036-00 | — | NIVELES PLASMATICOS ZINC | $46.500 | $46.500 |
| 33-02-039-00 | — | FOSFATASAS ALCALINAS C/SEPARACION ISOENZ | $52.000 | $52.000 |
| 33-02-050-01 | — | ADENOSINDEAMINASA EN LIQUIDOS | $96.305 | $96.305 |
| 33-02-058-00 | — | OSMOLALIDAD, SANGRE EXAMEN BIOQUIMICO | $27.650 | $27.650 |
| 33-02-087-00 | — | VANCOMICINA (C/DETERM.) | $63.994 | $63.994 |
| 33-02-092-00 | — | FENOBARBITAL LIBRE (CADA DETERM.) | $21.251 | $21.251 |
| 33-02-092-01 | — | NIVELES DE FENOBARBITAL (UC) | $99.410 | $99.410 |
| 33-02-094-00 | — | ACIDO VALPROICO, NIVEL DE (UC) | $99.410 | $99.410 |
| 33-02-094-01 | — | CARBAMAZEPINA NIVELES DE(UC) | $61.120 | $61.120 |
| 33-02-095-00 | — | PARACETAMOL, NIVEL DE | $83.500 | $83.500 |
| 33-02-096-00 | — | TEGRETAL, NIVEL DE | $21.251 | $21.251 |
| 33-02-098-01 | — | PANEL DE DROGAS DE ABUSO (TRIAGE) | $214.890 | $214.890 |
| 33-02-098-02 | — | TOXICOLOGICO,ANALISIS DE | $240.876 | $240.876 |
| 33-02-102-00 | — | ACIL-CARNITINA | $27.200 | $27.200 |
| 33-02-116-00 | — | PEPTIDO NATRIURETICO (BNP) | $82.437 | $82.437 |
| 33-02-120-00 | — | HOMOCISTEINA | $187.000 | $187.000 |
| 33-02-121-00 | — | MUTACION ENZIMA MTFHR | $126.585 | $126.585 |
| 33-02-133-00 | — | ENZIMA CONVERTIDORA DE ANGIOTENSINA I | $59.250 | $59.250 |
| 33-03-002-00 | — | ALDOSTERONA | $16.283 | $16.283 |
| 33-03-003-00 | — | ANDROSTENEDIONA | $11.110 | $11.110 |
| 33-03-009-00 | — | ERITROPOYETINA | $84.500 | $84.500 |
| 33-03-014-00 | — | PCR PARA HONGOS EN LIQUIDOS | $198.200 | No disponible |
| 33-03-021-00 | — | RENINA | $55.730 | $55.730 |
| 33-03-032-00 | — | AC. VAINILLILMANDELICO, CUANTITATIVO | $14.095 | $14.095 |
| 33-03-034-00 | — | CATECOLAMINAS | $89.700 | $89.700 |
| 33-03-036-00 | — | ESTRIOL | $14.182 | $14.182 |
| 33-03-047-00 | — | INSULINE LIKE GROWTH FACTOR | $15.240 | $15.240 |
| 33-03-049-00 | — | IGF BINDING PROTEIN -1(IGFBP-1) | $15.700 | $15.700 |
| 33-03-050-00 | — | IGF BINDING PROTEIN -3 (IGFBP-3) | $15.700 | $15.700 |
| 33-03-113-00 | — | PEPTIDO C (INS) | $27.700 | $27.700 |
| 33-04-001-00 | — | CARIOGRAMA FIBROBLASTOS POR CULTIVO TROF | $525.030 | $525.030 |
| 33-04-001-01 | — | INMUNOFENOTIPO CITOMETRIA FLUJO LEUCEMI | $302.903 | $302.903 |
| 33-04-002-00 | — | CARIOTIPO EN SANGRE PERIFERICA | $166.930 | $166.930 |
| 33-04-004-00 | — | FERTILIDAD FEMENINA ESTUDIO MOLECULAR | $130.000 | $130.000 |
| 33-04-005-00 | — | FERTILIDAD MASCULINA ESTUDIO MOLECULAR | $130.000 | $130.000 |
| 33-04-006-00 | — | RIESGO PREECLAMPSIA | $65.000 | $65.000 |
| 33-04-007-00 | — | RIESGO HELLP | $65.000 | $65.000 |
| 33-04-008-00 | — | GENES ASOCIADOS A DIABETES GESTACIONAL | $104.000 | $104.000 |
| 33-04-009-00 | — | TEST PRENATAL TRISOMIAS 13,18 NO INVASIV | $520.000 | $520.000 |
| 33-04-010-00 | — | TEST PRENATAL NO INVASIVO AMPLIADO | $650.000 | $650.000 |
| 33-04-011-00 | — | SEXO FETAL EN SANGRE MATERNA | $109.850 | $109.850 |
| 33-04-012-00 | — | TROMBOFILIAS EXAMEN MOLECULAR | $65.650 | $65.650 |
| 33-04-013-00 | — | BRCA 1/2 | $195.000 | $195.000 |
| 33-04-014-00 | — | ESTUDIO MOLECULAR CANCER ENDOMETRIO | $195.000 | $195.000 |
| 33-04-015-00 | — | INESTABILIDAD MICROSATELITAL CA ENDOMETR | $156.000 | $156.000 |
| 33-04-016-00 | — | ESTUDIO MOLECULAR CANCER OVARIO | $325.000 | $325.000 |
| 33-04-017-00 | — | RESISTENCIA QUIMIOTERAPICO ESPECIFICO | $66.950 | $66.950 |
| 33-04-018-00 | — | GENES ASOCIADOS A PROLAPSO | $104.650 | $104.650 |
| 33-04-019-00 | — | COLAGENOPATIAS PISO PELVICO | $105.300 | $105.300 |
| 33-04-104-00 | — | CARIOGRAMA MEDULA OSEA | $166.927 | $166.927 |
| 33-05-001-00 | — | ALFA -1- ANTITRIPSINA CUANTITATIVA | $7.185 | $7.185 |
| 33-05-005-00 | — | ANTICUERPOS ANTIMITOCONDRIALES M2 | $53.570 | $53.570 |
| 33-05-006-00 | — | PANEL MARCADORES INMUNOLOGICOS DIABETES | $69.430 | $69.430 |
| 33-05-007-01 | — | ANTICUERPOS ANTI LKM-1 | $41.800 | $41.800 |
| 33-05-007-08 | — | ANTIPROTEINASA 3 | $31.200 | No disponible |
| 33-05-007-09 | — | ANTICUERPOS ANTIMIELOPEROXIDASA | $31.200 | $31.200 |
| 33-05-008-00 | — | PANEL IgE ESPECIFICA PARA 22 ALERGENOS | $33.000 | $33.000 |
| 33-05-013-00 | — | INTERLEUKINA-6 | $40.000 | $40.000 |
| 33-05-020-00 | — | ANTICUERPOS ANTI BETA-2 GLICOPROTEINA 1 | No disponible | $35.000 |
| 33-05-022-01 | — | CUANTIFICACION CADENAS LIVIANAS KAPPA LA | $143.260 | No disponible |
| 33-05-025-00 | — | INMUNOFIJACION INMUNOGLOBULINAS SANGRE | $46.200 | No disponible |
| 33-05-025-01 | — | INMUNOFIJACION INMUNOGLOBULINAS ORINA | $46.200 | $46.200 |
| 33-05-027-00 | — | ANTICUERPOS ANTIMEMBRANA BASAL GLOMERULA | $14.670 | $14.670 |
| 33-05-028-00 | — | BETA-D GLUCANO | $220.800 | $220.800 |
| 33-05-029-00 | — | IGE ESPECIFICA PARA AMPICILINA | $9.000 | $9.000 |
| 33-05-050-00 | — | SUBPOBLACION LINFOCITARIA | $401.200 | $401.200 |
| 33-05-060-00 | — | TIPIFICACION HLA B-27 | $60.900 | $60.900 |
| 33-05-070-00 | — | CA 125, CA 15-3 , CA 19-9 | $15.148 | $15.148 |
| 33-05-081-00 | — | ANTITRANSGLUTAMINASA TISULAR | $23.000 | $23.000 |
| 33-05-090-00 | — | ANCA-C | $12.984 | $12.984 |
| 33-05-091-00 | — | ANCA-P | $12.984 | $12.984 |
| 33-05-096-00 | — | AC ANTICELULAS DE ISLOTES | $54.050 | $54.050 |
| 33-05-097-00 | — | ANTICUERPOS ANTIRECEPTORES DE TSH (TRAB) | $33.100 | $33.100 |
| 33-05-098-00 | — | ANTICUERPOS ANTI AQUAPORINA -4 NMO/MOG | $156.000 | $156.000 |
| 33-05-099-00 | — | ANTICUERPOS ANTINEURONALES PARANEOPLA | $234.000 | $234.000 |
| 33-05-100-00 | — | ESTUDIO DE ISOINMUNIZACIÓN (IDENTIFICACI | $31.500 | $31.500 |
| 33-05-104-02 | — | PCR PARA CITOMEGALOVIRUS | $226.915 | $226.915 |
| 33-05-108-00 | — | CALPROTECTINA CUANTITATIVA POR ELISA | $29.000 | $29.000 |
| 33-05-110-00 | — | AC ANTI -HMGRC | $169.700 | $169.700 |
| 33-05-114-00 | — | TAMIZAJE AC (A-ENA) ,SM,RNP,RO,LA,SCL7,J | $108.000 | $108.000 |
| 33-05-145-00 | — | PANEL ENCEFALITIS AUTOINMUNE SUERO Y LCR | $758.330 | No disponible |
| 33-05-146-00 | — | PANEL MIOPATIAS INFLAMATORIAS | $245.128 | $245.128 |
| 33-05-147-00 | — | PANEL ENCEFALITIS AUTOINMUNES EN LCR | $410.650 | $410.650 |
| 33-05-148-00 | — | PANEL AMPLIADO 22 PATOGEN GASTRO POR PCR | $328.210 | $328.210 |
| 33-05-149-00 | — | PANEL ENF. HEPATICAS AUTOINMUNES(9 ANG) | $115.000 | $115.000 |
| 33-05-150-00 | — | PANEL ANA 23 AUTOANTICUERPOS IGG | $62.680 | $62.680 |
| 33-05-501-00 | — | INMUNOFENOTIPO LINFOPROLIFERATIVO | $236.596 | $236.596 |
| 33-06-021-00 | — | CULTIVO ADENOVIRUS | No disponible | $48.200 |
| 33-06-022-00 | — | HEMOCULTIVO PARA MYCOBACTERIAS | $127.950 | $127.950 |
| 33-06-030-00 | — | IGE ESPECIFICA PARA GENTAMICINA | $9.000 | $9.000 |
| 33-06-031-00 | — | IGE ESPECIFICA PARA METRONIDAZOL | $9.000 | $9.000 |
| 33-06-032-00 | — | ASPERGILOSIS, CANDIDIASIS, HISTOPLASMOSI | $10.550 | $10.550 |
| 33-06-039-01 | — | LATEX CRIPTOCOCOS | $65.600 | $65.600 |
| 33-06-046-00 | — | CRYPTOSPORIDIUM SP, ISOSPORA BELLI, CYCL | $88.710 | $88.710 |
| 33-06-061-00 | — | ELISA INDIRECTA (CHAGAS, HIDATIDOSIS, TO | $6.655 | $6.655 |
| 33-06-061-01 | — | HIDATIDOSIS SEROLOGIA | $20.700 | $20.700 |
| 33-06-061-02 | — | TRIQUINOSIS ANTICUERPOS IGG | $7.267 | $7.267 |
| 33-06-062-00 | — | FIJACION DEL COMPLEMENTO (DISTOMATOSIS, | $16.416 | $16.416 |
| 33-06-068-00 | — | AISLAMIENTO VIRAL CITOMEGALOVIRUS | $95.273 | $95.273 |
| 33-06-069-03 | — | EPSTEIN BARR ANTICUERPOS VIRALES IGG | $7.400 | $10.240 |
| 33-06-069-04 | — | PARVOVIRUS IG M | $59.440 | No disponible |
| 33-06-069-05 | — | PARVOVIRUS IG G | $59.440 | No disponible |
| 33-06-069-07 | — | PAROTIDITIS IGM | $43.200 | $43.200 |
| 33-06-069-08 | — | VARICELA ZOSTER ANTICUERPOS IGG,U | $31.300 | $31.300 |
| 33-06-069-09 | — | VARICELA ZOSTER ANTICUERPOS IGM,U | $31.300 | $31.300 |
| 33-06-069-10 | — | EPSTEIN BARR, ANTICUERPOS IGM ANTI VCA | $39.000 | $39.000 |
| 33-06-069-11 | — | PCR PANEL VIRUS RESPIRATORIO (BK 16) | $90.000 | $90.000 |
| 33-06-069-14 | — | EPSTEIN BARR ANTICUERPOS VIRALES IGM | $7.400 | $7.400 |
| 33-06-076-00 | — | VIRUS HEPATITIS B, ANTICORE TOTAL DEL | No disponible | $9.407 |
| 33-06-076-01 | — | AC ANTI ANTIGENO DE SUPERF. HEPATITIS B | $12.370 | $12.370 |
| 33-06-082-00 | — | SARS COV2 VITA PCR EXPRESS CORONAVIRUS | $49.990 | $25.600 |
| 33-06-101-00 | — | CARGA VIRAL DE VIH | $239.920 | $239.920 |
| 33-06-101-01 | — | NEUMOCOCO DETECCION DE ANTIGENO EN ORINA | $54.900 | $54.900 |
| 33-06-102-00 | — | PCR PNEUMOCYSTIS JIROVECII | $227.115 | $227.115 |
| 33-06-105-00 | — | CARGA VIRAL DE CITOMEGALOVIRUS | $153.550 | $153.550 |
| 33-06-107-00 | — | ASPERGILLUS (GALACTOMANANA) POR ELISA | $145.680 | No disponible |
| 33-06-110-00 | — | FILMARRAY SEPSIS | $280.000 | $280.000 |
| 33-06-115-00 | — | TOXOCARIASIS, ELISA | $16.732 | $16.732 |
| 33-06-118-00 | — | PANEL DE NEUMONIAS BACTERIANAS | $42.990 | $42.990 |
| 33-06-123-00 | — | LEPTOSPIRA, SEROLOGIA | $49.000 | $49.000 |
| 33-06-124-00 | — | PCR PANEL HERPES I Y II/VARICELA ZOSTER | $179.690 | $179.690 |
| 33-06-124-01 | — | PCR PARA VIRUS HERPES HUMANO TIPO 6 | $147.330 | No disponible |
| 33-06-124-02 | — | PCR PARA VIRUS VARICELA ZOSTER | $130.366 | No disponible |
| 33-06-125-00 | — | PCR MYCOBACTERIUM TUBERCULOSIS | $196.485 | $196.485 |
| 33-06-125-01 | — | PCR PARA CLOSTRIDIUM DIFFICILE C | $99.000 | $99.000 |
| 33-06-127-00 | — | CHLAMYDIA PNEUMONIAE IG M | $10.900 | No disponible |
| 33-06-127-01 | — | CHLAMYDIA PNEUMONIAE IG G | $7.500 | $7.500 |
| 33-06-127-04 | — | CHLAMIDIA PSITTACI-PNEU-TRACH. IG M | $69.012 | $69.012 |
| 33-06-127-05 | — | CHLAMIDIA PSITTACI-PNEU-TRACH IG G | $69.012 | $69.012 |
| 33-06-128-00 | — | SEROLOGIA BRUCELOSIS | $10.500 | $10.500 |
| 33-06-129-00 | — | PCR PARA ENTEROVIRUS | $161.630 | $161.630 |
| 33-06-131-00 | — | BARTONELLA SEROLOGIA IGG | $30.000 | $30.000 |
| 33-06-131-02 | — | BARTONELLA SEROLOGIA IGM | $30.000 | $30.000 |
| 33-06-132-00 | — | PCR PARA VIH | $88.821 | $88.821 |
| 33-06-134-02 | — | P.C.R. PARA MYCOPLASMA PNEUM0NIAE | $76.000 | $76.000 |
| 33-06-136-00 | — | PCR BORDETELLA PERTUSIS | $59.900 | $59.900 |
| 33-06-137-00 | — | PRE ALBUMINA | $29.900 | $29.900 |
| 33-06-138-00 | — | QUANTIFERON TB | $273.890 | $273.890 |
| 33-06-139-00 | — | SEROLOGIA FASCIOLA HEPATICA | $68.000 | $68.000 |
| 33-06-140-00 | — | PATOGENO PARTO PREMATURO | $65.650 | $65.650 |
| 33-06-141-00 | — | PCR PATOGENOS DE TRANSMISION SEXUAL | $48.500 | $48.500 |
| 33-06-142-00 | — | GEN TIPIFICACION DE VIRUS PAPILOMA 30 TI | $77.350 | $77.350 |
| 33-06-143-00 | — | PCR PARA CHAGAS | $81.706 | $81.706 |
| 33-06-144-00 | — | SEROLOGIA BORRELIA BURGDORFERI | $130.173 | $130.173 |
| 33-06-145-00 | — | PANEL RAPIDO MOLECULAR MENINGITIS | $380.750 | $380.750 |
| 33-06-150-00 | — | PCR VIRUELA MONO | $62.000 | $62.000 |
| 33-06-151-00 | — | ESTUDIO CREUTZFELD - JAKOB | $155.000 | $155.000 |
| 33-06-154-00 | — | PANEL NEUMONIA AMPLIADO | $330.000 | $330.000 |
| 33-06-156-00 | — | CYSTOISPORA BELLI TINCION ZIEHL NIELSEN | $35.000 | $35.000 |
| 33-06-171-00 | — | ANTICUERPOS VIRALES SARAMPION IGG | $14.490 | $14.490 |
| 33-06-172-00 | — | ANTICUERPOS VIRALES SARAMPION IGM | $14.490 | $14.490 |
| 33-06-176-00 | — | ANTIGENO E DE HEPATITIS B | $57.500 | $57.500 |
| 33-06-201-00 | — | ANTIFUNFIGRAMA AUTOMATIZADO LEVADURAS | $17.000 | $17.000 |
| 33-06-682-00 | — | PCR SARS COVID(CORONA VIRUS) | $25.150 | $25.600 |
| 33-08-010-01 | — | LAVADO BRONQUIALVEOLAR RECUENTO Y FORMUL | $17.500 | $17.500 |
| 33-08-019-00 | — | PROTEINAS, ELECTROFORESIS DE (INCLUYE PR | $9.455 | $9.455 |
| 33-08-020-00 | — | BANDAS OLIGOCLONALES (INCLUYE ELECTROFOR | $136.670 | $42.850 |
| 33-08-021-00 | — | GLUTAMINA | $6.618 | $6.618 |
| 33-08-036-00 | — | FOSFATIDIL GLICEROL Y/O FOSFATIDIL INOSI | $16.727 | $16.727 |
| 33-08-070-00 | — | EXAMEN VDRL- LCR | $22.004 | $22.004 |
| 33-08-101-00 | — | ESTEATOCRITO | $61.520 | $61.520 |
| 33-09-005-00 | — | ACIDO 5 HIDROXIINDOLACETICO CUANTITATIVO | $14.261 | $14.261 |
| 33-09-007-00 | — | AMINOACIDOS CUANTITATIVOS EN ORINA | $17.700 | $17.700 |
| 33-09-008-00 | — | ACIDO AMINOLEVULINICO (ALA) | $92.700 | $92.700 |
| 33-09-017-00 | — | HIDROXIPROLINA EN ORINA | $14.095 | $14.095 |
| 33-09-019-00 | — | MUCOPOLISACARIDOS | $14.636 | $14.636 |
| 33-09-025-00 | — | OSMOLALIDAD | $5.673 | $5.673 |
| 33-09-026-00 | — | OSMOLARIDAD, EXAMEN DE ORINA | $27.600 | $27.600 |
| 33-09-029-00 | — | PROTEINAS DE BENCE-JONES PRUEBA TERMICA | $2.609 | $2.609 |
| 33-09-030-00 | — | CITRATO EN ORINA DE 24 HORAS | $18.000 | $18.000 |
| 33-09-038-00 | — | PORFOBILINOGENO | $73.500 | $73.500 |
| 33-09-052-00 | — | OXALATURIA | $18.000 | $18.000 |
| 33-09-053-00 | — | LEGIONELLA ANTIG.URINARIO | $51.700 | $51.700 |
| 43-01-045-00 | — | RECUENTO HEMATOLOGICO AUTOMATIZADO | $4.980 | $4.980 |
| 43-02-010-00 | — | AMONIO | $13.500 | $13.500 |
| 43-05-007-00 | — | ANTICUERPOS ANTI TPO (PEROXIDASA) | $7.550 | $7.550 |
| 43-05-085-00 | — | PEPTIDO CITRULADO ANTICUERPO IGG | $16.000 | $16.000 |
| 43-06-037-00 | — | TEST PACK MYCOPLASMA PNEUMONIAE | $22.000 | $22.000 |
| 43-06-070-00 | — | TEST PACK VRS | $25.000 | $25.000 |
| 43-06-070-01 | — | ADENOVIRUS RESPIRATORIO TEST RAPIDO | $16.000 | $16.000 |
| 43-06-070-02 | — | TEST PACK INFLUENZA | $16.000 | $16.000 |
| 43-06-070-03 | — | TEST PACK INFLUENZA A Y B | $21.000 | $21.000 |
| 43-06-070-04 | — | METAPNEUMOVIRUS POR INMUNOFLUORESCENCIA | $11.000 | $11.000 |
| 43-06-101-00 | — | LATEX LIQUIDO CEFALORRAQUIDEO MENINGITIS | $33.000 | $33.000 |
| 43-06-131-00 | — | DETECCION HELICOBACTER PYLORI EN DEPOSIC | $26.500 | $26.500 |
| 43-06-132-00 | — | ANTI HELICOBACTER PYLORI IGG | $26.500 | $26.500 |
| 43-06-133-00 | — | PCR PARA INFLUENZA A Y B | $48.000 | $48.000 |
| 43-06-682-00 | — | TEST RAPIDO SARS COV -2 IGG/IGM | $9.660 | $9.660 |
| 43-08-005-00 | — | HEMOGLOBINA HUMANA EN DEPOSICIONES | $3.500 | $3.500 |
| Código CHP | Código Fonasa | Nombre prestación | Valor particular | Valor Fonasa |
|---|---|---|---|---|
| 02-01-001-00 | 0201001 | DIA CAMA CUIDADO BASICO INDIVIDUAL | $342.786 | $339.056 |
| 02-01-002-00 | 0201002 | DIA CAMA CUIDADO BASICO HAB DOBLE | $243.724 | $241.072 |
| 02-01-101-00 | 0201101 | DIA CAMA CUIDADO MEDIO INDIVIDUAL | $387.911 | $383.690 |
| 02-01-102-00 | 0201102 | DIA CAMA CUIDADO MEDIO DOBLE | $325.790 | $322.245 |
| 02-01-201-00 | 0201201 | DIA CAMA ADULTO CUIDADO INTENSIVO (UCI) | $912.174 | $902.249 |
| 02-01-301-00 | 0201301 | DIA CAMA INTERMEDIO ADULTO | $656.670 | $649.525 |
| 02-01-302-00 | 0201302 | DIA CAMA INTERMEDIO PEDIATRIA | $617.542 | $610.823 |
| 02-01-303-00 | 0201303 | DIA CAMA INTERMEDIO NEONATAL | $502.858 | $497.387 |
| 02-01-401-00 | 0201401 | DIA CAMA OBSTETRICIA INDIVIDUAL | $342.786 | $339.056 |
| 02-01-402-00 | 0201402 | DIA CAMA OBSTETRICIA DOBLE | $243.724 | $241.072 |
| 02-01-403-00 | 0201403 | SALA CUNA | $125.942 | $124.572 |
| 02-01-407-00 | 0201407 | DIA CAMA OBSERVACION | $136.687 | $135.200 |
| 02-01-408-00 | 0201408 | DIA CAMA DE RECUPERACION | $60.000 | No disponible |
| 02-02-401-00 | 0202401 | DIA CAMA DE OBSERVACION (0 - 4 HRS) | $70.000 | No disponible |
| 02-02-402-00 | 0202402 | DIA CAMA DE OBSERVACION (HASTA 8 HRS) | $100.000 | No disponible |
| 02-02-403-00 | 0202403 | DIA CAMA DE OBSERVACION (HASTA 12 HRS) | $136.687 | No disponible |
| 02-02-404-00 | 0202404 | DIA CAMA DE OBSERVACION (HORA ADICIONAL) | $12.000 | No disponible |
| Código CHP | Nombre prestación | Valor particular | Valor Fonasa |
|---|---|---|---|
| 80-10-001-00 | SALA 1 | $33.000 | $30.000 |
| 80-10-002-00 | SALA 2 | $35.000 | $33.720 |
| 80-10-002-01 | SALA 2 GASTROENTEROLOGÍA | $35.000 | $33.720 |
| 80-10-002-02 | SALA 2 BILATERAL | $40.227 | $50.580 |
| 80-10-002-03 | SALA 2 50% | $17.500 | $16.860 |
| 80-10-003-00 | SALA 3 | $67.000 | $65.000 |
| 80-10-003-01 | SALA 3 GASTROENTEROLOGÍA | $83.000 | $80.000 |
| 80-10-003-02 | SALA 3 FIBROSCOPIA | $67.000 | $65.000 |
| 80-10-003-03 | SALA 3 GASTRO 50% | $43.245 | $40.000 |
| 80-10-003-05 | SALA CISTOMETRIA | $25.000 | $25.000 |
| 80-10-003-06 | SALA 3 50% | $28.828 | $32.500 |
| 80-10-004-00 | SALA 4 | $103.000 | $101.900 |
| 80-10-004-01 | SALA 4 HISTEROSCOPIA | $103.000 | $101.900 |
| 80-10-005-00 | SALA 1 OFTALMOLOGIA | $28.000 | $25.000 |
| 80-10-005-01 | SALA 1 OFTALMOLOGIA 50% (BILATERAL) | $14.000 | $12.500 |
| 80-10-006-00 | SALA 2 OFTALMOLOGÍA | $35.000 | $33.720 |
| 80-10-007-00 | SALA 3 OFTALMOLOGÍA | $67.000 | $65.000 |
| 80-10-007-01 | SALA 3 OFT BILATERAL | $86.489 | $32.500 |
| 80-10-008-00 | SALA 4 OFTALMOLOGÍA | $103.000 | $101.900 |
| 80-10-008-02 | SALA 4 OFTALMOLOGIA BILATERAL 50% | $50.950 | $50.950 |
| 80-10-009-00 | SALA CIRUGIA MENOR | $28.000 | $25.000 |
| 80-30-001-00 | PABELLON 1 | $70.000 | $69.995 |
| 80-30-004-00 | PABELLON 4 | $163.590 | No disponible |
| 80-30-005-00 | PABELLON 5 | $900.000 | $900.000 |
| 80-30-006-01 | PABELLON PARTO | $541.550 | No disponible |
| 80-30-007-01 | PABELLON CESAREA | $623.460 | No disponible |
| 80-30-007-02 | PABELLON LIPOSUCCION | $424.000 | $400.000 |
| 80-30-013-00 | PABELLON 13 | $954.721 | No disponible |
| 80-30-014-00 | PABELLON 14 | $2.758.008 | No disponible |
| Código CHP | Nombre prestación | Valor particular | Valor Fonasa |
|---|---|---|---|
| 05-01-134-00 | DENSITOMETRIA OSEA A FOTON DOBLE, COLUMN | $43.380 | $60.990 |
| Código CHP | Código Fonasa | Nombre prestación | Valor particular | Valor Fonasa |
|---|---|---|---|---|
| 06-01-101-00 | — | EVALUACION KINESIOLOGICA INTEGRAL | $3.680 | $3.680 |
| 06-01-103-00 | — | ATENCION KNT INTEGRAL HOSPITALIZADOS | $12.500 | $12.500 |
| 06-01-104-00 | — | ATENCION KNT INTEGRAL UPC INTENSIVO | $23.580 | $23.580 |
| 06-01-104-01 | — | ATENCION KNT INTEGRAL INTERMEDIO | $23.580 | No disponible |
| 06-01-105-00 | — | ATENCION KINESIOLOGIA INTEGRAL AMBULATOR | $11.390 | $11.390 |
| 07-02-101-00 | — | PRODUCCION DE GLOBULO ROJO | $55.910 | $31.060 |
| 07-02-102-00 | — | PRODUCCION DE CONCENTRADO DE PLAQUETAS E | $13.190 | $7.330 |
| 07-02-103-00 | — | PRODUCCION DE PLASMA O CRIOPRECIPITADO | $11.970 | $6.650 |
| 07-02-109-00 | — | IRRADIACION COMPONENTE SANGUINEO UNIDAD | $8.350 | $4.640 |
| 07-02-110-00 | — | FILTRACION DE GLOBULOS ROJOS O PLAQUETAS | $78.890 | $43.830 |
| 07-02-201-00 | — | CALIFICACION MICROBIOLOGICA POR DONANTE | $59.360 | $32.980 |
| 07-02-202-00 | — | CALIFICACION INMUNOHEMATOLOGICA DONANTE | $28.750 | $15.970 |
| 07-02-203-00 | — | PRUEBA COMPATIBILIDAD UNIDAD G ROJOS | $6.550 | $3.640 |
| 07-02-207-00 | — | DETECCION ANTICUERPOS IRREGULARES ERITR | $7.360 | $4.090 |
| 07-02-208-00 | — | GRUPOS MENORES. TIPIFICACION O DETERMINA | $7.870 | $4.370 |
| 07-02-301-00 | — | TRANSFUSION EN ADULTOS POR UNIDAD GR-PLA | $23.310 | $12.950 |
| 07-02-302-00 | — | TRANSFUSION NIÑO UNIDAD GR,PLASMA,PLAQU | $28.080 | $15.600 |
| 07-02-303-00 | — | TRANSFUSION UNIDAD GR,PLASMA,PLAQUETAS | $33.660 | $18.700 |
| 07-02-304-00 | — | SANGRIA | $18.320 | $10.180 |
| 07-02-305-00 | — | RECAMBIO PLASMATICO POR AFERESIS TERAPEU | $664.420 | No disponible |
| 08-01-001-00 | — | CITODIAGNOSTICO CORRIENTE, EXFOLIATIVA ( | $11.380 | $11.380 |
| 08-01-001-01 | — | PAP FASE LIQUIDA | $25.000 | $25.000 |
| 08-01-002-00 | — | CITOLOGIA NO GINECOLOGICA POR CADA PLACA | $16.580 | $16.580 |
| 08-01-003-00 | — | ** ESTUDIO HISTOPATOLOGICO CON MICROSCOP | $66.740 | $66.740 |
| 08-01-004-00 | — | ** ESTUDIO HISTOPATOLOGICO CON TECNICAS | $49.280 | $49.280 |
| 08-01-005-00 | — | ESTUDIO HISTOPATOLOGICO CON TECNICAS | $36.020 | $36.020 |
| 08-01-006-00 | — | ESTUDIO HISTOPATOLOGICO DE BIOPSIA CONT | $47.860 | $47.860 |
| 08-01-007-00 | — | ESTUDIO HISTOPATOLOGICO CON TINCION CORR | $47.860 | $47.860 |
| 08-01-008-00 | — | ESTUDIO HISTOPATOLOGICO CORRIENTE DE BIO | $24.800 | $24.800 |
| 08-01-009-00 | — | NECROPSIA DE ADULTO O NINO, CON ESTUDIO | $126.110 | $126.110 |
| 08-01-010-00 | — | NECROPSIA DE FETO O RECIEN NACIDO, CON E | $107.950 | $107.950 |
| 08-01-011-00 | — | PCR MARCADORES TUMORALES HISTOLOGIA | $783.010 | $489.380 |
| 08-01-012-00 | — | INMUNO HISTOQUIMICA MARCADOR TUMORAL ALK | $272.220 | $170.140 |
| 08-01-108-00 | — | HISTOLOGIA BIOPSIA OSEA | No disponible | $267.060 |
| 09-01-005-00 | — | ATENCION PSIQUIATRICA O PSICOTERAPIA DE | $50.000 | $46.690 |
| 09-02-002-00 | — | PSICOTERAPIA INDIVIDUAL(SESIONES 45 MIN) | $28.000 | $20.980 |
| 09-02-003-00 | — | PSICOTERAPIA DE PAREJA (CADA MIEMBRO DE | $28.000 | $20.980 |
| 09-02-011-00 | — | TEST DE RELACIONES OBJETALES | $37.060 | $38.350 |
| 09-02-012-00 | — | TEST T.A.T. O C.A.T. | $35.580 | $36.830 |
| 09-02-013-00 | — | TEST DE EDWARDS | $17.420 | $18.030 |
| 09-02-014-00 | — | TEST DE M.M.P.I. | $16.720 | $17.310 |
| 09-02-015-00 | — | TEST DE WESCHLER,WISC R,WAIS | $27.250 | $28.210 |
| 09-02-015-01 | — | TEST DE WESCHLER -WAIS _WISC-R | $45.580 | $28.210 |
| 09-02-016-00 | — | TEST DE DOMINO Y RAVEN | $17.420 | $18.030 |
| 09-02-017-00 | — | TEST DE BENDER | $16.720 | $17.310 |
| 09-02-018-00 | — | BENDER BIP | $16.720 | $17.310 |
| 09-02-019-00 | — | TEST DE GOLDSTEIN | $27.220 | $28.180 |
| 09-02-020-00 | — | TEST DE LURIA-NEBRASKA | $46.930 | $48.580 |
| 09-02-110-00 | — | TEST DE FAMILIA | $15.000 | $15.000 |
| 11-01-001-00 | — | Rellenado de bombas de administración d | $34.560 | $22.210 |
| 11-01-002-00 | — | PUNCION SUBDURAL | $32.690 | $21.010 |
| 11-01-003-00 | — | PUNCION LUMBAR C/S MANOMETRIA /QUECKENST | $23.530 | $15.120 |
| 11-01-004-00 | — | E.E.G. DE 16 O MAS CANALES (INCLUYE EL C | $65.690 | $42.210 |
| 11-01-005-00 | — | ELECTROCORTICOGRAFIA | $87.500 | $56.220 |
| 11-01-007-00 | — | ESTEREO-ELECTROENCEFALOGRAFIA (INCLUYE U | $100.100 | $64.320 |
| 11-01-008-00 | — | MONITOREO E.E.G. (ELECTRODOS IMPLANTADOS | $43.280 | $27.810 |
| 11-01-009-00 | — | ELECTROMIOGRAFIA DE FIBRA UNICA | $66.860 | $42.960 |
| 11-01-010-00 | — | ELECTROMIOGRAFIAS CUALQUIER REGION, POR | $40.340 | $25.920 |
| 11-01-010-01 | — | ELECTROMIOGRAFIA MUSCULOS INTERCOSTALES | $40.340 | $25.920 |
| 11-01-011-00 | — | POTENCIALES EVOCADOS EN CORTEZA ( POR EJ | $52.810 | $33.940 |
| 11-01-012-00 | — | VELOCIDAD DE CONDUCCION (INCLUYE REFLEJO | $32.970 | $21.180 |
| 11-01-013-00 | — | CAROTIDA-VERTEBRAL POR CATETERIZACION DE | $86.900 | $55.840 |
| 11-01-025-00 | — | POR PUNCION LUMBAR, CON MEDIO DE CONTRAS | $41.630 | $26.750 |
| 11-01-026-00 | — | DE NERVIOS PERIFERICOS INTRAMUSCULAR (DE | $34.540 | $22.190 |
| 11-01-027-00 | — | DE NERVIOS PERIFERICOS TRONCULAR | $26.270 | $29.500 |
| 11-01-028-00 | — | DE RAMAS DEL TRIGEMINO O DEL FACIAL | $24.280 | $15.600 |
| 11-01-029-00 | — | DEL GANGLIO ESTRELLADO | $24.900 | $16.000 |
| 11-01-030-00 | — | INFILTRACION O BLOQUEO EPIDURAL ,CERVICA | $36.880 | $24.110 |
| 11-01-031-00 | — | INTERCOSTALES (CUALQUIER NUMERO) | $34.540 | $22.190 |
| 11-01-032-00 | — | RIZOTOMIA QUIMICA POR MEDIO DE INYECCION | $68.950 | $44.300 |
| 11-01-033-00 | — | SUBOCCIPITAL U OTROS NERVIOS CERVICALES | $24.900 | $16.000 |
| 11-01-034-00 | — | INTRAMUSCULAR | $33.490 | $21.520 |
| 11-01-035-00 | — | INTRATECAL | $57.890 | $37.200 |
| 11-01-036-00 | — | TRONCULAR | $47.190 | $30.320 |
| 11-01-040-00 | — | E.E.G. POST-PRIVACION DE SUENO (INCLUYE | $91.910 | $59.060 |
| 11-01-042-00 | — | E.E.G. DIGITAL (CON ACTIVACIONES) 20 CAN | $77.540 | $49.820 |
| 11-01-043-00 | — | E.E.G. DIGITAL (CON ACTIVACIONES) 32 CAN | $100.320 | $64.460 |
| 11-01-044-00 | — | MONITOREO E.E.G. CONTINUO DE 24 HRS. | $161.850 | $104.000 |
| 11-01-046-00 | — | ELECTROENCEFALOGRAMA DIGITAL DE 32 CANAL | $109.440 | $70.320 |
| 11-01-050-00 | — | POLISOMNOGRAFIA BASAL HOSPITALIZADO | $222.030 | $142.670 |
| 11-01-052-00 | — | POLISOMNOGRAFIA BASAL AMBULATORIA | $222.410 | $142.910 |
| 11-01-053-00 | — | POLISOMNOGRAFIA CON TITULACION CPAP/VMNI | $255.900 | $164.430 |
| 11-01-113-00 | — | ANGIOGRAFIA CEREBRAL POR CATETERIZACION | $86.900 | No disponible |
| 11-01-130-00 | — | ANGIOGRAFIA CEREBRAL | $118.180 | $55.840 |
| 11-01-140-00 | — | ANGIOGRAFIA MEDULAR | $54.860 | $54.860 |
| 11-01-200-00 | — | BLOQUEO/INFILTRACION NERVIO PERIFERICO | $80.000 | $80.000 |
| 11-01-300-00 | — | BLOQUEO/INFILTRACION EPIDURAL O CAUDAL | $155.000 | $155.000 |
| 11-01-400-00 | — | INFILTRACION FACETARIA (RADIOFRECUENCIA) | $26.270 | $200.000 |
| 11-01-500-00 | — | BLOQUEO DEL TRIGEMINO | $24.280 | $15.600 |
| 11-03-001-00 | — | ANEURISMA CIRSOIDEO DE CUERO CABELLUDO, | $118.180 | $237.390 |
| 11-03-002-00 | — | SINUS PERICRANI, TRAT.QUIR. | $118.180 | $230.260 |
| 11-03-003-00 | — | HUNDIMIENTO SIMPLE, REPARACION DE | $314.190 | $243.680 |
| 11-03-004-00 | — | CREANEOPLASTIA CON AUTOINJERTO | $314.190 | $249.980 |
| 11-03-005-00 | — | CRANEOPLASTIA CON PROTESIS (NO INCLUYE E | $314.190 | $249.980 |
| 11-03-006-00 | — | TUMORES DE CALOTA, EXTIRP. DE | $314.190 | $238.030 |
| 11-03-007-00 | — | OSTEOMIELITIS, LIMPIEZA QUIRURGICA | $314.190 | $250.670 |
| 11-03-008-00 | — | CRANIECTOMIAS DESCOMPRESIVAS | $314.190 | $331.040 |
| 11-03-009-00 | — | REPARACION DE FRACTURA CRECEDORA | $314.190 | $499.580 |
| 11-03-010-00 | — | CRANEOTOMIAS LINEALES | $314.190 | $515.300 |
| 11-03-011-00 | — | CRANIECTOMIAS C/S REMODELACION OSEA | $530.150 | $886.140 |
| 11-03-012-00 | — | - HONORARIOS DEL 1ER. CIRUJANO RESPONSAB | $530.150 | $962.620 |
| 11-03-013-00 | — | - HONORARIOS C/U DE LOS OTROS 1ROS. CIRU | $1.128.440 | $725.100 |
| 11-03-014-00 | — | HEMATOMA O ABSCESO EXTRADURAL, VACIAMIEN | $314.190 | $572.960 |
| 11-03-015-00 | — | REPARACION DE FISTULA DE LCR | $314.190 | $383.680 |
| 11-03-016-00 | — | HEMATOMA, EMPIEMA O COLECCION SUBDURAL, | $314.190 | $572.960 |
| 11-03-017-00 | — | QUISTES ARACNOIDALES ENCEFALICOS, TRAT. | $530.150 | $511.620 |
| 11-03-018-00 | — | VENTRICULOSTOMIA O INSTALACION DE DERIVA | $314.190 | $250.670 |
| 11-03-018-01 | — | INSTALACION CAPTOR PIC EN UCI | $390.110 | $250.670 |
| 11-03-019-00 | — | ABSCESO CEREBRAL, TRAT. QUIR. | $530.150 | $771.260 |
| 11-03-020-00 | — | HERIDA POR BALA CRANEOENCEFALICA Y/O EXT | $314.190 | $515.300 |
| 11-03-021-00 | — | HUNDIMIENTO EXPUESTO, REPAR. DE | $314.190 | $322.720 |
| 11-03-022-00 | — | LOBECTOMIAS POR CONTUSION CEREBRAL | $530.150 | $642.690 |
| 11-03-023-00 | — | HEMATOMA INTRACEREBRAL, VACIAMIENTO DE | $530.150 | $614.720 |
| 11-03-024-00 | — | DE BASE DE CRANEO | $530.150 | $1.126.430 |
| 11-03-025-00 | — | INTRAORBITARIOS | $530.150 | $1.098.110 |
| 11-03-026-00 | — | ENCEFALICOS Y DE HIPOFISIS | $530.150 | $1.126.430 |
| 11-03-027-00 | — | ANEURISMAS, MALFORMACIONES ARTERIOVENOSA | $530.150 | $1.040.300 |
| 11-03-028-00 | — | FISTULA CAROTIDO CAVERNOSA TRATAMIENTO E | $314.190 | $508.460 |
| 11-03-029-00 | — | FISTULA CAROTIDO CAVERSONA, TRAT.QUIR. | $530.150 | $636.640 |
| 11-03-030-00 | — | ANASTOMOSIS Y REVASCULARIZACION CEREBRAL | $314.190 | $527.790 |
| 11-03-031-00 | — | ANASTOMOSIS Y REVASCULARIZACION CEREBRAL | $530.150 | $1.084.610 |
| 11-03-032-00 | — | INSTALACION DE DERIVATIVAS DE LCR (NO IN | $314.190 | $393.550 |
| 11-03-033-00 | — | REVISION O EXTERIORIZACION DE DERIVATIVA | $118.180 | $250.670 |
| 11-03-034-00 | — | VENTRICULOCISTERNOSTOMIA | $314.190 | $390.560 |
| 11-03-035-00 | — | FENESTRACION, SEPTOSTOMIA O COAGULACION | $530.150 | $390.560 |
| 11-03-036-00 | — | CIRUGIA DESCOMPRESIVA DE FOSA POSTERIOR | $530.150 | $678.910 |
| 11-03-037-00 | — | MENINGO Y MENINGOENCEFALOCELE OCCIPITAL, | $530.150 | $680.540 |
| 11-03-038-00 | — | CIRUGIA DESCOMPRESIVA NEUROVASCULAR. | $530.150 | $758.130 |
| 11-03-039-00 | — | NEUROTOMIAS | $118.180 | $276.700 |
| 11-03-040-00 | — | NEUROLISIS O MICROCOMPRESION PERCUTANEA | $118.180 | $390.560 |
| 11-03-041-00 | — | CIRUGIA DE LA EPILEPSIA (CUALQUIER TECNI | $530.150 | $698.100 |
| 11-03-042-00 | — | BIOPSIA | $530.150 | $759.300 |
| 11-03-043-00 | — | COAGULACION DE NUCLEOS O VIAS ENCEFALICA | $530.150 | $883.170 |
| 11-03-045-00 | — | IMPLANTACION DE ESTIMULADORES INTRACRANE | $530.150 | $595.860 |
| 11-03-046-00 | — | INSTALACION DE ESTIMULADORES MEDULARES | $314.190 | $369.070 |
| 11-03-047-00 | — | DISRRAFIAS ESPINALES: MENINGOCELE, MIELO | $530.150 | $678.910 |
| 11-03-048-00 | — | INFILTRACION FACETARIA COLUMNA Y RADICUL | $118.180 | $300.420 |
| 11-03-049-00 | — | HERNIA NUCLEO PULPOSO, ESTENORRAQUIS, AR | $314.190 | $784.420 |
| 11-03-049-01 | — | HNP CERVICAL | $314.190 | $784.420 |
| 11-03-050-00 | — | LAMINECTOMIA DESCOMPRESIVA | $314.190 | $659.260 |
| 11-03-051-00 | — | HERIDAS RAQUIMEDULARES, TRAT. QUIR. | $314.190 | $506.130 |
| 11-03-052-00 | — | TUMOR VERTEBRAL, TRAT. QUIR. | $314.190 | $558.540 |
| 11-03-053-00 | — | TUMOR O QUISTE MEDULAR O INTRARRAQUIDEO, | $530.150 | $680.530 |
| 11-03-054-00 | — | MALFORMACION ARTERIOVENOSA O FISTULA DUR | $530.150 | $776.380 |
| 11-03-055-00 | — | CORDOTOMIA PERCUTANEA | $118.180 | $369.070 |
| 11-03-056-00 | — | MIELOTOMIA, DREZTOMIA | $314.190 | $607.300 |
| 11-03-057-00 | — | RIZOTOMIA (CUALQUIER TECNICA) | $314.190 | $467.330 |
| 11-03-058-00 | — | TUMOR DE NERVIO PERIFERICO, EXTIRP. DE | $118.180 | $230.740 |
| 11-03-059-00 | — | REPARACION PLEXOS C/S NEUROTIZACION CON | $314.190 | $745.280 |
| 11-03-060-00 | — | SECCION DE NERVIO, REPARACION CON INJER | $314.190 | $376.050 |
| 11-03-061-00 | — | SECCION DE NERVIO, REPARACION SIN INJERT | $118.180 | $333.570 |
| 11-03-062-00 | — | NEUROLISIS CON TECNICA MICROQUIRURGICA | $314.190 | $356.210 |
| 11-03-063-00 | — | NEUROLISIS EXTERNA | $118.180 | $250.450 |
| 11-03-064-00 | — | SINDROME DEL ESCALENO, TRAT. QUIR. | $118.180 | $302.340 |
| 11-03-065-00 | — | SINDROME DE COSTILLA CERVICAL,TRAT.QUIR. | $118.180 | $542.300 |
| 11-03-066-00 | — | SINDROME DEL TUNEL DEL CARPO O DEL TARSO | $118.180 | $250.450 |
| 11-03-067-00 | — | TRANSPOSICION CUBITAL, REPAR. DE | $118.180 | $300.510 |
| 11-03-068-00 | — | NEURECTOMIA, CUALQUIER LOCALIZACION, CAD | $118.180 | $220.260 |
| 11-03-068-01 | — | NEURECTOMIA POR LAPAROSCOPIA | $314.190 | $220.260 |
| 11-03-069-00 | — | FIJACION DE COLUMNA (CERVICAL-DORSAL-LUM | $314.190 | $652.690 |
| 11-03-127-00 | — | EMBOLIZACION ANEURISMA CEREBRAL | $2.132.000 | $1.022.210 |
| 11-03-227-00 | — | EMBOLIZACION MAV | $1.022.210 | $1.022.210 |
| 11-03-300-01 | — | TROMBECTOMIA MECANICA CEREBRAL CON CATET | $530.150 | No disponible |
| 11-03-300-02 | — | TROMBECTOMIA MECANICA CEREBRAL CON STENT | $530.150 | No disponible |
| 11-03-300-03 | — | TROMBECTOMIA MECANICA CEREBRAL SIST ASPI | $530.150 | $2.319.218 |
| 11-03-400-00 | — | TROMBECTOMIA MECANICA TECNICA COMBINADA | No disponible | $2.003.048 |
| 12-01-001-00 | — | & CAMPIMETRIA DE PROYECCION, C/OJO (PROC | $18.820 | $12.100 |
| 12-01-002-00 | — | & COORDIMETRIA, TEST DE HESS U OTRO, C/O | $9.610 | $6.180 |
| 12-01-003-00 | — | CUANTIFICACION DE LAGRIMACION (TEST DE | $5.830 | $3.740 |
| 12-01-004-00 | — | CURVA DE TENSION APLANATICA (POR CADA | $14.690 | $9.440 |
| 12-01-005-00 | — | DIPLOSCOPIA CUANTITATIVA, AMBOS OJOS | $8.470 | $5.440 |
| 12-01-006-00 | — | & ELECTROMIOGRAFIA MUSCULOS OCULARES ADU | $39.620 | $25.460 |
| 12-01-007-00 | — | & ELECTROMIOGRAFIA MUSCULOS OCULARES NIN | $36.800 | $23.650 |
| 12-01-008-00 | — | & ELECTROOCULOGRAFIA, AMBOS OJOS | $32.720 | $21.020 |
| 12-01-009-00 | — | EXPLORACION SENSORIOMOTORA: ESTRABISMO | $34.140 | $21.940 |
| 12-01-010-00 | — | & PERIMETRIA ESTATICA (CON CAMPIMETRIA D | $29.160 | $18.740 |
| 12-01-011-00 | — | PRUEBAS DE PROVOCACION PARA GLAUCOMA ( | $19.020 | $12.220 |
| 12-01-012-00 | — | & RETINOGRAFIA, AMBOS OJOS | $21.910 | $14.080 |
| 12-01-014-00 | — | TONOMETRIA OCULAR CUALQUIER TE, C/OJO | $4.880 | $3.140 |
| 12-01-015-00 | — | TRATAMIENTO ORTOPTICO Y/ O PLEOPTICO ( | $10.830 | $6.960 |
| 12-01-017-00 | — | ANGIOSCOPIA RETINAL Y/O IRIS (CON FLUORE | $9.560 | $6.140 |
| 12-01-018-00 | — | ELECTRORRETINOGRAFIA, C/OJO | $29.510 | $18.960 |
| 12-01-019-00 | — | EXPLORACION VITREORRETINAL, AMBOS OJOS | $17.650 | $11.340 |
| 12-01-020-00 | — | ECOBIOMETRIA CON CALCULO DE LENTE INTRAO | $60.530 | $38.900 |
| 12-01-023-00 | — | & POTENCIAL VISUAL EVOCADO EN ADULTOS, A | $45.190 | $29.040 |
| 12-01-024-00 | — | & POTENCIAL VISUAL EVOCADO EN NINOS, AMB | $44.720 | $28.740 |
| 12-01-027-00 | — | OPTOMETRIA | $32.870 | No disponible |
| 12-01-029-00 | — | CUERPO EXTRANO CONJUNTIVAL Y/O CORNEAL E | $22.930 | $14.740 |
| 12-01-030-00 | — | CUERPO EXTRANO CONJUNTIVAL Y/O CORNEAL E | $35.430 | $22.770 |
| 12-01-031-00 | — | VIA LAGRIMAL,CATETERISMO EN ADULTOS | $34.540 | $22.190 |
| 12-01-031-01 | — | VIA LAGRIMAL EN AD BILATERAL | $10.905 | $10.905 |
| 12-01-032-00 | — | VIA LAGRIMAL, CATETERISMO EN LACTANTES | $57.420 | $36.900 |
| 12-01-033-00 | — | VIA LAGRIMAL, CATETERISMO EN NIÑOS | $44.550 | $28.620 |
| 12-01-034-00 | — | TOCACION CORNEAL C/YODO Y/O ETER U OTROS | $16.410 | $10.540 |
| 12-01-035-00 | — | CRIOCOAGULACION CONJUNTIVAL, CORNEAL O P | $26.270 | $22.190 |
| 12-01-036-00 | — | CRIOCOAGULACION CONJUNTIVAL, CORNEAL O P | $26.270 | $24.640 |
| 12-01-037-00 | — | GLAUCOMA, CICLODIATERMIA Y/O CICLOCRIOTE | $26.270 | $82.080 |
| 12-01-039-00 | — | PESTANAS, EXTIRP. POR ELECTROCOAGULACION | $38.350 | $24.640 |
| 12-01-040-00 | — | PUNTOS LAGRIMALES ELECTROTERMOCOAGULACI | $34.540 | $22.190 |
| 12-01-041-00 | — | SONDAJE VIA LAGRIMAL EN NINOS (BAJO ANES | $26.270 | $111.250 |
| 12-01-042-00 | — | CAMPIMETRIA COMPUTARIZADA, C/OJO | $43.130 | $27.710 |
| 12-01-043-00 | — | TOPOGRAFIA CORNEAL COMPUTARIZADA, C/OJ | $73.430 | $47.180 |
| 12-01-044-01 | — | TOMOGRAFIA COHERENCIA OPTICA C/OJO | $139.270 | $55.930 |
| 12-01-045-00 | — | PAQUIMETRIA | $89.340 | $35.880 |
| 12-01-100-00 | — | MICROSCOPIA ESPECULAR | $35.000 | $35.000 |
| 12-01-200-00 | — | INYECCION INTRAVITREA | $80.000 | $80.000 |
| 12-02-001-00 | — | INTUBACION | $26.270 | $115.390 |
| 12-02-002-00 | — | PUNTOS LAGRIMALES, PLASTIA DE | $26.270 | $80.700 |
| 12-02-002-01 | — | PLASTIA LAGRIMAL BILATERAL | $39.650 | $39.650 |
| 12-02-003-00 | — | RECONSTITUCION DE CANALICULOS | $26.270 | $184.660 |
| 12-02-004-00 | — | ABSCESO, VACIAMIENTO Y/O DRENAJE DE | $77.960 | $50.100 |
| 12-02-005-00 | — | DACRIOCISTORRINOSTOMIA | $26.270 | $283.220 |
| 12-02-006-00 | — | EXTIRPACION DE | $26.270 | $153.730 |
| 12-02-007-00 | — | RECONSTITUCION VIA LAGRIMAL EN AUSENCIA | $118.180 | $377.900 |
| 12-02-008-00 | — | TUMOR DE GLANDULA LAGRIMAL, TRAT. QUIR. | $118.180 | $390.560 |
| 12-02-009-00 | — | TUMOR MALIGNO DEL SACO, TRAT. QUIR. COM | $118.180 | $283.220 |
| 12-02-010-00 | — | ABSCESO, TRAT. QUIR. | $26.270 | $46.160 |
| 12-02-011-00 | — | BIOPSIA DE PARPADO Y/O ANEXOS (PROC. AUT | $104.730 | $67.300 |
| 12-02-011-01 | — | BIOPSIA PARPADO BILATERAL | $42.984 | $33.065 |
| 12-02-012-00 | — | BLEFAROCHALASIS, PLASTIA DE | $233.190 | $149.840 |
| 12-02-012-01 | — | BLEFAROCHALASIS PLASTIA BILATERAL | $233.190 | $149.840 |
| 12-02-013-00 | — | BLEFAROFIMOSIS, PLASTIA DE | $118.180 | $290.800 |
| 12-02-014-00 | — | BLEFARORRAFIA CON BLEFAROTOMIA POSTERIOR | $26.270 | $80.700 |
| 12-02-015-00 | — | CANTOPLASTIA | $26.270 | $115.390 |
| 12-02-016-00 | — | CHALAZION Y OTROS TUMORES BENIGNOS (UNO | $139.710 | $89.780 |
| 12-02-016-01 | — | CHALAZION BILATERAL | $139.710 | $89.780 |
| 12-02-017-00 | — | COLOBOMA, PLASTIA DE | $118.180 | $245.940 |
| 12-02-018-00 | — | ECTROPION, PLASTIA DE | $26.270 | $181.870 |
| 12-02-019-00 | — | ENTROPION, PLASTIA DE | $26.270 | $181.870 |
| 12-02-020-00 | — | EPICANTO, PLASTIA DE | $26.270 | $181.870 |
| 12-02-021-00 | — | PTOSIS, TRAT. QUIR. | $118.180 | $294.720 |
| 12-02-021-01 | — | PEXIA CILIAR | $118.180 | $294.720 |
| 12-02-022-00 | — | QUISTE DERMOIDE DE LA COLA DE LA CEJA, R | $26.270 | $92.210 |
| 12-02-023-00 | — | TUMOR MALIGNO, TRAT. QUIR. COMPLETO | $118.180 | $184.660 |
| 12-02-024-00 | — | XANTELASMA, TRAT. QUIR. | $109.830 | $70.580 |
| 12-02-025-00 | — | HERIDA O DEHISCENCIA, SUTURA DE (PROC.AU | $26.270 | $145.980 |
| 12-02-026-00 | — | PTERIGION Y/O PSEUDOPTERIGION O SU RECID | $26.270 | $171.250 |
| 12-02-027-00 | — | SIMBLEFARON, RESECCION DE ADHERENCIAS Y | $118.180 | $151.140 |
| 12-02-028-00 | — | TUMOR BENIGNO, EXTIRP. DE | $26.270 | $89.780 |
| 12-02-029-00 | — | ABSCESO, TRAT. QUIR. | $129.700 | $83.340 |
| 12-02-030-00 | — | CORRECCION DE CAVIDAD ANOFTALMICA TRAT. | $118.180 | $349.890 |
| 12-02-031-00 | — | CUERPO EXTRANO ORBITARIO (CON ORBITOTOMI | $118.180 | $365.380 |
| 12-02-032-00 | — | EXANTERACION ORBITARIA O TUMOR ORBITARIO | $314.190 | $673.700 |
| 12-02-033-00 | — | ORBITOTOMIA ANTERIOR | $118.180 | $189.820 |
| 12-02-034-00 | — | ORBITOTOMIA LATERAL DESCOMPRESIVA | $118.180 | $292.930 |
| 12-02-035-00 | — | BIOPSIA DE GLOBO OCULAR (PROC. AUT) | $118.180 | $138.430 |
| 12-02-036-00 | — | ENUCLEACION O IMPLANTE DE PROTESIS OCULA | $118.180 | $253.810 |
| 12-02-037-00 | — | ENUCLEACION CON IMPLANTE | $118.180 | $346.020 |
| 12-02-038-00 | — | ESTRABISMO, TRAT. QUIR. COMPLETO (UNO O | $118.180 | $413.220 |
| 12-02-039-00 | — | EXANTERACION OCULAR (PROC. AUT.) | $118.180 | $253.810 |
| 12-02-040-00 | — | LESION TRAUMATICA, SUTURA DE (PROC. AUT. | $118.180 | $179.390 |
| 12-02-041-00 | — | CIRUGIA REFRACTIVA, QUERATOTOMIA RADIAL | $118.180 | $236.850 |
| 12-02-042-00 | — | CRIOTERAPIA Y RECESION CONJUNTIVAL | $26.270 | $128.110 |
| 12-02-044-00 | — | CUERPO EXTRANO, EXTRACCION QUIR. DE | $26.270 | $53.790 |
| 12-02-045-00 | — | GLAUCOMA, TRAT. QUIR. POR CUALQUIER TECN | $314.190 | $356.210 |
| 12-02-046-00 | — | HERIDA PENETRANTE CORNEAL O CORNEO-ESCLE | $118.180 | $230.740 |
| 12-02-047-00 | — | QUERATECTOMIA LAMINAR | $118.180 | $229.810 |
| 12-02-048-00 | — | QUERATOPLASTIA. INJERTO LAMELAR O PENETR | $118.180 | $493.260 |
| 12-02-049-00 | — | QUERATOPROTESIS, IMPLANTACION DE (NO INC | $314.190 | $538.020 |
| 12-02-050-00 | — | RECUBRIMIENTO CONJUNTIVAL | $118.180 | $276.830 |
| 12-02-051-00 | — | REHABILITACION SUPERFICIE OCULAR (CON IN | $118.180 | $276.830 |
| 12-02-053-00 | — | IRIDECTOMIA PERIFERICA Y/U OPTICA, (PROC | $118.180 | $179.890 |
| 12-02-054-00 | — | TUMOR, TRAT. QUIR. | $118.180 | $348.500 |
| 12-02-055-00 | — | DESGARRO SIN DESPRENDIMIENTO, DIATERMO Y | $26.270 | $184.660 |
| 12-02-056-00 | — | DESPRENDIMIENTO RETINAL, CIRUGIA CONVENC | $118.180 | $480.480 |
| 12-02-057-00 | — | RETINOPATIA PROLIFERATIVA, (DIABETICA, H | $568.390 | $365.230 |
| 12-02-058-00 | — | TUMOR, DIATERMO Y/O CRIO Y/O FOTOCOAGULA | $26.270 | $189.420 |
| 12-02-059-00 | — | VASCULOPATIA RETINAL (EXCEPTO RETINOPATI | $26.270 | $219.740 |
| 12-02-060-00 | — | VITRECTOMIA C/RETINOTOMIA (C/S INYECCION | $118.180 | $658.480 |
| 12-02-061-00 | — | VITRECTOMIA CON INYECCION DE GAS O SILIC | $118.180 | $540.560 |
| 12-02-062-00 | — | VITRECTOMIA CON VITREOFAGO (PROC. AUT) | $118.180 | $474.080 |
| 12-02-063-00 | — | FACOERESIS INTRACAPSULAR O CATARATA SE | $118.180 | $393.570 |
| 12-02-064-00 | — | FACOERESIS EXTRACAPSULAR CON IMPLANTE | $118.180 | $625.890 |
| 12-02-065-00 | — | IMPLANTE SECUNDARIO DE LENTE INTRAOCULAR | $314.190 | $604.770 |
| 12-02-066-00 | — | ASPIRACION ESFERULAR C/S CAPSULOTOMIA | $118.180 | $184.910 |
| 12-02-067-00 | — | DISCISION DE CAPSULA POSTERIOR | $26.270 | $184.610 |
| 12-02-067-01 | — | DISCISION CAPSULA POSTERIOR BILAT 50 % | $26.270 | $92.305 |
| 12-02-068-00 | — | IRIDOTOMIA | $26.270 | $184.610 |
| 12-02-068-01 | — | IRIDOTOMIA BILATERAL 50% | $26.270 | $92.305 |
| 12-02-069-00 | — | TRABECULOPLASTIA O IRIDOPLASTIA | $26.270 | $184.610 |
| 12-02-069-01 | — | TRABECULOPLASTIA BILATERAL 50% | $26.270 | $92.305 |
| 12-02-070-00 | — | SINEQUIOTOMIA (PROC. AUT.) | $118.180 | $153.730 |
| 12-02-071-00 | — | HERIDA O DEHISCENCIA DE SUTURA DE PARPAD | $172.530 | $110.860 |
| 12-02-072-00 | — | RECONSTRUCCION DE PISO ORBITARIO. | $118.180 | $238.030 |
| 12-02-073-00 | — | OPERACION TRIPLE (INJERTO, FACOERESIS E | $314.190 | $818.050 |
| 12-02-074-00 | — | HERNIA DE IRIS Y/O FISTULAS,REPARACION D | $118.180 | $184.660 |
| 12-02-075-00 | — | RETINOPEXIA NEUMATICA. | $118.180 | $374.580 |
| 12-02-076-00 | — | EXTRACCION O CORRECCION DE DESPLAZAMIENT | $118.180 | $353.570 |
| 12-02-077-00 | — | DESPRENDIMIENTO COROIDEO O HEMORRAGIA CO | $118.180 | $184.660 |
| 12-02-078-00 | — | CIRUGIA FOTORREFRACTIVA (LASIK) | $118.180 | $760.960 |
| 13-01-001-00 | — | ELECTROGUSTOMETRIA | $12.750 | $8.190 |
| 13-01-003-00 | — | NASOFARINGOLARINGOFIBROSCOPIA | $43.550 | $27.980 |
| 13-01-005-00 | — | SINUSOSCOPIA DE CADA SENO MAXILAR POR PU | $23.510 | $15.100 |
| 13-01-006-00 | — | CON MICROSCOPIO | $54.230 | $34.850 |
| 13-01-007-00 | — | - SIN MICROSCOPIO | $47.340 | $30.420 |
| 13-01-008-00 | — | AUDIOMETRIA EN NINOS | $25.650 | $16.480 |
| 13-01-009-00 | — | IMPEDANCIOMETRIA | $16.360 | $10.510 |
| 13-01-010-00 | — | & PRUEBA DE AUDIFONOS | $13.750 | $8.830 |
| 13-01-011-00 | — | & AUDIOMETRIA POR POTENCIALES EVOCADOS | $48.130 | $30.930 |
| 13-01-012-00 | — | COCLEOVESTIBULAR CON ELECTRONISTAGMOG | $44.020 | $28.290 |
| 13-01-015-00 | — | & ELECTRONISTAGMOGRAFIA C/S NISTAG.DE P | $16.090 | $10.340 |
| 13-01-016-00 | — | & PERMEABILIDAD TUBARIA, ESTUDIO INSTRU | $12.380 | $7.950 |
| 13-01-017-00 | — | & PRUEBA CALORICA (PROC.AUT.) | $11.480 | $7.380 |
| 13-01-019-00 | — | & TEST DE GLICEROL (CON DOS AUDIOMETRIA | $43.350 | $27.860 |
| 13-01-020-00 | — | VIII PAR, ESTUDIO DE ( EXAMEN COCLEOV | $48.680 | $31.280 |
| 13-01-021-00 | — | AUDIOMETRIA | $21.910 | $14.080 |
| 13-01-024-00 | — | SENOS PERINASALES, PUNCION EVACUADORA C/ | $17.180 | $11.040 |
| 13-01-025-00 | — | TAPONAMIENTO ANTERIOR (PROC. AUT.) | $12.150 | $7.810 |
| 13-01-026-00 | — | TAPONAMIENTO POSTERIOR | $35.430 | $22.770 |
| 13-01-027-00 | — | VACIAMIENTO CAVID. PERINASALES (PROETZ Y | $66.460 | $42.700 |
| 13-01-028-00 | — | VASOS Y/O CORNETES, ELECTROCAUTERIZACION | $26.270 | $22.770 |
| 13-01-029-00 | — | CUERPO EXTRAÑO NASAL EN ADULTOS | $16.410 | $10.540 |
| 13-01-030-00 | — | CUERPO EXTRAÑO NASAL EN NINOS | $37.520 | $24.110 |
| 13-01-035-00 | — | EN ADULTOS | $26.270 | $42.940 |
| 13-01-036-00 | — | EN NINOS | $26.270 | $50.110 |
| 13-01-037-00 | — | DILATACION ESOFAGICA POR SESION | $26.270 | $11.140 |
| 13-01-038-00 | — | EN NINOS | $26.270 | $45.490 |
| 13-01-039-00 | — | EN ADULTOS | $26.270 | $45.490 |
| 13-01-040-00 | — | LESIONES DEL OIDO EXTERNO Y/O MEDIO, CUR | $11.530 | $7.410 |
| 13-01-041-00 | — | TROMPA DE EUSTAQUIO, INSUFLACION INSTRUM | $11.530 | $7.410 |
| 13-01-042-00 | — | CUERPO EXTRAÑO OIDO ADULTOS | $11.530 | $7.410 |
| 13-01-043-00 | — | CUERPO EXTRAÑO OIDO EN NIÑOS | $34.540 | $22.190 |
| 13-01-044-00 | — | BIOPSIA OIDO (PROC. AUT.) | $34.540 | $22.190 |
| 13-01-100-00 | — | EMISIONES OTOACUSTICAS | $19.700 | $19.700 |
| 13-01-101-00 | — | TRATAMIENTO VESTIBULAR SESION 1 | $32.500 | $32.500 |
| 13-01-200-00 | — | VIDEONASOLARINGOSCOPIA | $68.000 | $68.000 |
| 13-02-001-00 | — | ABSCESO Y/O HEMATOMAS OIDO EXTERNO | $53.710 | $34.510 |
| 13-02-002-00 | — | CUERPO EXTRANO EN CONDUCTO AUDITIVO EXTE | $26.270 | $75.200 |
| 13-02-003-00 | — | FISTULA PREAURICULAR COMPLICADA, TRAT. Q | $369.790 | $237.620 |
| 13-02-003-01 | — | FISTULA PREAURICULAR COMPLICADA, 1CIRUJ | $369.790 | $237.620 |
| 13-02-004-00 | — | TUMOR BENIGNO, TRAT. QUIR. | $73.900 | $47.490 |
| 13-02-005-00 | — | TUMOR MALIGNO, TRAT. QUIR. | $26.270 | $236.690 |
| 13-02-006-00 | — | ESTAPEDECTOMIA | $118.180 | $280.800 |
| 13-02-007-00 | — | MASTOIDECTOMIA C/S SECCION CUERDA DEL TI | $118.180 | $313.820 |
| 13-02-008-00 | — | MUCOSITIS TIMPANICA O MIXIOSIS UNI O BIL | $26.270 | $184.910 |
| 13-02-009-00 | — | OPERACION RADICAL DEL OIDO C/S SECCION C | $118.180 | $276.830 |
| 13-02-011-00 | — | RECONSTITUCION FUNCIONAL DE OIDO RADICAL | $118.180 | $353.310 |
| 13-02-012-00 | — | TIMPANOPLASTIA FUNCIONAL (CUALQUIER TIPO | $118.180 | $284.880 |
| 13-02-013-00 | — | AGENESIA O ESTENOSIS, RECONSTITUCION PLA | $118.180 | $354.530 |
| 13-02-014-00 | — | EXOSTOSIS, RESECCION RETRO O ENDOAURAL | $118.180 | $251.280 |
| 13-02-015-00 | — | NEURECTOMIA DE JACOBSON | $118.180 | $230.740 |
| 13-02-016-00 | — | RECONSTITUCION DE CONDUCTO AUDITIVO EXTE | $118.180 | $304.980 |
| 13-02-017-00 | — | TUMOR GLOMICO, TRAT. QUIR. | $118.180 | $363.940 |
| 13-02-018-00 | — | LABERINTECTOMIA | $118.180 | $292.930 |
| 13-02-019-00 | — | NEURINOMA DEL ACUSTICO, TRAT. QUIR. VIA. | $118.180 | $514.640 |
| 13-02-020-00 | — | DESCOMPRESION INTRAOSEA C/S PLASTIA | $118.180 | $276.830 |
| 13-02-021-00 | — | LESIONES A NIVEL DEL CONDUCTO AUDITIVO I | $118.180 | $448.430 |
| 13-02-022-00 | — | BIOPSIA BUCO-FARINGEA (PROC. AUT.) | $56.700 | $36.430 |
| 13-02-023-00 | — | ** SECCION SIMPLE Y/O RESECCION FRENILLO | $53.710 | $34.510 |
| 13-02-024-00 | — | PISO DE LA BOCA | $26.270 | $35.390 |
| 13-02-025-00 | — | DRENAJE ABCESO PERIAMIGDALIANO | $97.630 | $62.740 |
| 13-02-026-00 | — | RETROFARINGEO O FARINGOLARINGEO | $26.270 | $62.740 |
| 13-02-027-00 | — | VESTIBULO BUCAL | $56.800 | $36.500 |
| 13-02-028-00 | — | ADENOIDECTOMIA (PROC. AUT.) | $118.180 | $200.720 |
| 13-02-029-00 | — | AMIGDALECTOMIA C/S ADENOIDECTOMIA, UNI O | $118.180 | $210.560 |
| 13-02-030-00 | — | CALCULOS SALIVALES, TRAT. QUIR. | $58.320 | $37.470 |
| 13-02-031-00 | — | TUMOR BENIGNO DE LA MUCOSA BUCAL, EXTIR | $53.710 | $34.510 |
| 13-02-032-00 | — | TUMOR MALIGNO DE LAS AMIGDALAS, TRAT. QU | $118.180 | $230.740 |
| 13-02-033-00 | — | TUMOR BENIGNO DE LAS AMIGDALAS, TRAT. QU | $118.180 | $237.620 |
| 13-02-034-00 | — | - MALIGNO, C/S DISECCION RADICAL DE CUEL | $314.190 | $515.300 |
| 13-02-035-00 | — | FARINGOPLASTIA (CUALQ.TECN.), C/S DESPLA | $118.180 | $358.830 |
| 13-02-036-00 | — | FIBROANGIOMA DEL RINOFARINX, TRAT. QUIR. | $314.190 | $474.080 |
| 13-02-037-00 | — | GLOSECTOMIA TOTAL C/S DISECCION RADICAL | $314.190 | $512.500 |
| 13-02-038-00 | — | ABSCESOS Y HEMATOMA DEL TABIQUE NASAL, T | $26.270 | $55.580 |
| 13-02-039-00 | — | ARTERIA ESFENOPALATINA, CAUTERIZACION PO | $26.270 | $250.670 |
| 13-02-040-00 | — | ARTERIA MAXILAR INTERNA, LIGADURA DE (PO | $118.180 | $230.740 |
| 13-02-041-00 | — | ARTERIAS ETMOIDALES ANTERIORES, LIGADURA | $26.270 | $184.910 |
| 13-02-042-00 | — | TURBINECTOMIA O ELECTROCAUTERIZACION DE | $26.270 | $62.740 |
| 13-02-043-00 | — | CONDUCTO Y/O SENO LAGRIMAL, OBSTRUCCION | $118.180 | $230.740 |
| 13-02-044-00 | — | ETMOIDECTOMIA ENDO O EXONASAL | $118.180 | $243.570 |
| 13-02-045-00 | — | FISTULA BUCO-SINUSAL, TRAT. QUIR. | $118.180 | $250.670 |
| 13-02-046-00 | — | FRACT. NASAL RECIENTE, CERRADA O EXPUEST | $79.950 | $51.380 |
| 13-02-047-00 | — | NERVIO VIDIANO, SECCION DEL (POR CUALQUI | $118.180 | $283.970 |
| 13-02-048-00 | — | PERFORACION DEL TABIQUE, TRAT. QUIR. | $26.270 | $195.200 |
| 13-02-049-00 | — | POLIPO NASAL Y/O COANAL, TRAT. QUIR. | $26.270 | $62.180 |
| 13-02-050-00 | — | RINITIS ATROFICA, TRAT. POR INCLUSION SU | $118.180 | $184.910 |
| 13-02-051-00 | — | RINOFIMA, TRAT. QUIR. | $118.180 | $238.300 |
| 13-02-052-00 | — | RINOPLASTIA Y/O SEPTOPLASTIA, CUALQUIER | $118.180 | $314.370 |
| 13-02-053-00 | — | SENO ESFENOIDAL, ABERTURA (VIA TRANSETMO | $118.180 | $286.540 |
| 13-02-054-00 | — | SENO FRONTAL, TRAT.QUIR. C/S VACIAMIENTO | $118.180 | $243.570 |
| 13-02-055-00 | — | SENO MAXILAR, ANTROSTOMIA C/S ETMOIDECTO | $118.180 | $236.690 |
| 13-02-056-00 | — | SINEQUIA NASAL, TRAT. QUIR. | $26.270 | $35.390 |
| 13-02-057-00 | — | TUMOR NASAL, EXTIRP. POR RINOTOMIA LATER | $118.180 | $230.740 |
| 13-02-058-00 | — | VACIAMIENTO ETMOIDAL POR VIA NASAL C/S P | $118.180 | $175.550 |
| 13-02-059-00 | — | ARITENOIDECTOMIA VIA ENDOSCOPICA | $26.270 | $176.130 |
| 13-02-060-00 | — | ARITENOIDECTOMIA VIA EXTERNA | $118.180 | $230.740 |
| 13-02-061-00 | — | DECORTICACION DE CUERDAS VOCALES C/MICRO | $118.180 | $190.020 |
| 13-02-062-00 | — | POR LARINGOTOMIA | $26.270 | $184.660 |
| 13-02-063-00 | — | POR VIA ENDOSCOPICA | $26.270 | $194.940 |
| 13-02-064-00 | — | CORDECTOMIA LARINGEA O SINEQUIA CUERDAS | $118.180 | $230.740 |
| 13-02-065-00 | — | ESTENOSIS LARINGOTRAQUEALES Y/O FARINGEA | $118.180 | $515.300 |
| 13-02-066-00 | — | LARINGECTOMIA PARCIAL O SUBTOTAL (CUALQU | $118.180 | $486.900 |
| 13-02-067-00 | — | LARINGECTOMIA TOTAL MAS FARINGECTOMIA PA | $314.190 | $648.640 |
| 13-02-068-00 | — | LARINGECTOMIA TOTAL MAS FARINGECTOMIA TO | $530.150 | $893.570 |
| 13-02-069-00 | — | LARINGOCELE, TRAT. QUIR. | $118.180 | $224.940 |
| 13-02-070-00 | — | PAPILOMAS LARINGEOS, TRAT. QUIR. (POR SE | $26.270 | $89.780 |
| 13-02-071-00 | — | PARALISIS DE CUERDAS VOCALES, TRAT. QUIR | $118.180 | $237.870 |
| 13-02-072-00 | — | TRAQUEOSTOMIA (PROC. AUT.) | $118.180 | $250.670 |
| 13-02-073-00 | — | ESTENOSIS LARINGOTRAQUEALES Y FARINGEAS, | $26.270 | $121.810 |
| 13-02-350-00 | — | RINOSEPTOPLASTIA ADULTOS | $118.180 | No disponible |
| 13-03-010-00 | — | EVALUACION INTEGRAL FONOAUDIOLOGIA | $30.850 | $19.820 |
| 13-03-011-00 | — | REHABILITACION INTEGRAL DE FONOAUDIOLOGO | $14.270 | $9.170 |
| 14-01-001-00 | — | PUNCION EVACUADORA DE QUISTE TIROIDEO C/ | $35.430 | $80.000 |
| 14-01-001-01 | — | BIOPSIA CORE TIROIDES | $80.000 | $80.000 |
| 14-01-001-03 | — | PUNCION PLEURAL SIMPLE | $80.000 | $80.000 |
| 14-01-100-00 | — | PUNCION SEROMA BAJO ECO | $80.000 | $80.000 |
| 14-02-001-00 | — | TIROIDECTOMIA BILATERAL TOTAL | $118.180 | $487.870 |
| 14-02-002-00 | — | TIROIDECTOMIA BILATERAL SUBTOTAL | $118.180 | $347.010 |
| 14-02-003-00 | — | BOCIO INTRATORACICO, TRAT. QUIR. POR EST | $314.190 | $515.460 |
| 14-02-004-00 | — | TIROIDES LINGUAL, TRAT. QUIR. (OP.DE TRO | $314.190 | $461.260 |
| 14-02-005-00 | — | LOBECTOMIA CON O SIN ISTMECTOMIA O RESEC | $118.180 | $340.860 |
| 14-02-006-00 | — | TIROIDECTOMIA TOTAL AMPLIADA CON DISECCI | $314.190 | $832.740 |
| 14-02-007-00 | — | AUTOINJERTO DE PARATIROIDES (OPERACION | $118.180 | $334.780 |
| 14-02-008-00 | — | PARATIROIDES, EXPLORACION CERVICAL MAS E | $314.190 | $461.260 |
| 14-02-009-00 | — | PARATIROIDES, EXPLORACION CERVICAL POR H | $118.180 | $353.820 |
| 14-02-010-00 | — | PARATIROIDES, REINTERVENCION POR HIPERPA | $314.190 | $392.140 |
| 14-02-011-00 | — | PAROTIDECTOMIA PARCIAL (SUPRAFACIAL) | $118.180 | $237.440 |
| 14-02-012-00 | — | PAROTIDECTOMIA TOTAL | $118.180 | $352.370 |
| 14-02-013-00 | — | PAROTIDECTOMIA TOTAL AMPLIADA (INCLUYE M | $314.190 | $763.580 |
| 14-02-014-00 | — | TOTALIZACION DE PAROTIDECTOMIA PARCIAL | $314.190 | $343.490 |
| 14-02-015-00 | — | SUB-MANDIBULECTOMIA AMPLIADA (INCLUYE PI | $118.180 | $763.580 |
| 14-02-016-00 | — | SUB-MANDIBULECTOMIA | $118.180 | $237.440 |
| 14-02-017-00 | — | EXTIRPACION SUBLINGUAL | $118.180 | $189.680 |
| 14-02-018-00 | — | EXTIRPACION SUBLINGUAL AMPLIADA (INCLUYE | $118.180 | $763.580 |
| 14-02-019-00 | — | ABSCESO PAROTIDEO SUBMAXILAR Y/O CERVICA | $390.110 | $250.670 |
| 14-02-019-01 | — | ABCESO PAROTIDEO SUBMAXILAR 1 CIRUJANO | $390.110 | $250.670 |
| 14-02-020-00 | — | CONDUCTOS SALIVALES DE EXCRECION,REIMPLA | $118.180 | $230.860 |
| 14-02-021-00 | — | FISTULA SALIVAL, TRAT. QUIR. | $359.280 | $230.860 |
| 14-02-022-00 | — | MUCOCELE O QUISTE LABIAL, TRAT. QUIR. | $141.310 | $90.800 |
| 14-02-023-00 | — | TORTICOLIS CONGENITA, TRAT. QUIR. | $118.180 | $230.860 |
| 14-02-024-00 | — | QUISTES Y/O FISTULAS DEL CONDUCTO TIROGL | $118.180 | $230.860 |
| 14-02-025-00 | — | TUMORES DEL CUERPO CAROTIDEO, TRAT.QUIR. | $118.180 | $299.730 |
| 14-02-026-00 | — | BIOPSIA QUIR., MUCOSA ORONASOFARINGEA (P | $26.270 | $36.500 |
| 14-02-027-00 | — | BIOPSIA QUIR., PIEL Y MUCOSA CARA (PROC | $71.840 | $46.160 |
| 14-02-028-00 | — | RESECCION CUTANEA AMPLIADA(INCLUYE MUSCU | $118.180 | $230.740 |
| 14-02-029-00 | — | RESECCION CUTANEA SIMPLE (SUTURA PRIMARI | $26.270 | $75.200 |
| 14-02-030-00 | — | TUMOR MALIGNO DE LABIO SUPERIOR O INFERI | $118.180 | $289.570 |
| 14-02-031-00 | — | TUMOR MALIGNO DE LABIO SUPERIOR O INFERI | $118.180 | $230.740 |
| 14-02-032-00 | — | RESECCION PARCIAL Y CIRUGIA REPARADORA | $118.180 | $236.850 |
| 14-02-033-00 | — | RESECCION TOTAL Y CIRUGIA REPARADORA | $118.180 | $230.740 |
| 14-02-034-00 | — | RESECCION FRONTO-NASO-ETMOIDIANA | $118.180 | $292.160 |
| 14-02-035-00 | — | EXANTERACION ORBITARIA AMPLIADA (INCLUYE | $530.150 | $837.940 |
| 14-02-036-00 | — | HUESO TEMPORAL, EXTIRP. RADICAL | $314.190 | $791.810 |
| 14-02-037-00 | — | PARCIAL (INCLUYE PALADAR OSEO REPARACI | $118.180 | $297.060 |
| 14-02-038-00 | — | PARCIAL (INCLUYE PALADAR OSEO REPARACIO | $118.180 | $361.940 |
| 14-02-039-00 | — | RADICAL AMPLIADA(INCLUYE EXANTERACION OR | $530.150 | $791.810 |
| 14-02-040-00 | — | RADICAL CLASICA (INCLUYE EXANTERACION OR | $314.190 | $814.750 |
| 14-02-041-00 | — | RADICAL CLASICA(INCLUYE EXANTERACION ORB | $314.190 | $686.540 |
| 14-02-042-00 | — | GLOSECTOMIA PARCIAL, REPARACION PRIMARIA | $118.180 | $243.500 |
| 14-02-043-00 | — | RESECCION AMPLIA DE TUMOR MALIGNO Y DISE | $118.180 | $888.190 |
| 14-02-044-00 | — | HEMIMANDIBULECTOMIA | $118.180 | $368.780 |
| 14-02-045-00 | — | MANDIBULECTOMIA TOTAL | $314.190 | $576.510 |
| 14-02-046-00 | — | OPERACION "COMANDO" (INCLUYE EXTIRP. DEL | $530.150 | $868.580 |
| 14-02-047-00 | — | PARCIAL | $118.180 | $250.450 |
| 14-02-048-00 | — | RESECCION TRIDIMENSIONAL INTRA-ORAL O FA | $118.180 | $883.630 |
| 14-02-050-00 | — | FARINGECTOMIA PARCIAL | $118.180 | $230.740 |
| 14-02-051-00 | — | ** GENIOPLASTIA | $118.180 | $250.670 |
| 14-02-052-00 | — | ** OSTEOTOMIAS SEGMENTARIAS SOBRE MANDIB | $118.180 | $236.690 |
| 14-02-053-00 | — | ** OSTEOTOMIAS TOTALES SOBRE LA MANDIBUL | $118.180 | $414.510 |
| 14-02-054-00 | — | ** CON COLOCACION DE ARCOS Y/O FERULAS Y | $26.270 | $136.300 |
| 14-02-055-00 | — | ** CON OSTEOSINTESIS MULTIPLES,C/S LIGAD | $118.180 | $300.510 |
| 14-02-056-00 | — | ** CON OSTEOSINTESIS UNICA C/S COLOCACIO | $26.270 | $250.450 |
| 14-02-057-00 | — | RECONSTRUCCIONES COMPLEJAS DE LA CARA SI | $314.190 | $745.280 |
| 14-02-058-00 | — | RECONSTRUCCIONES DE PARTES DURAS Y BLAND | $118.180 | $508.460 |
| 14-02-059-00 | — | ** REMOCION QUIR. DE ARCOS Y/O ALAMBRES | $26.270 | $83.440 |
| 14-02-060-00 | — | SIMPLE (PROC.AUT.) | $119.620 | $76.860 |
| 15-02-001-00 | — | COMPLICADAS: 1 O VARIAS DE MAS DE 5 CM | $389.690 | $250.400 |
| 15-02-001-01 | — | SUTURA HERIDA COMPLEJA DE CARA 1 CIRUJA | $230.368 | $200.320 |
| 15-02-002-00 | — | SIMPLES: 1 O VARIAS DE HASTA 5 CMS. QU | $97.630 | $62.740 |
| 15-02-003-00 | — | IMPLANTE DE SILICONA FACIAL (CUALQUIER Z | $26.270 | $172.980 |
| 15-02-004-00 | — | CICATRICES HASTA 2 | $26.270 | $243.500 |
| 15-02-004-01 | — | CICATRICES HASTA 2 (1 CIRUJANO) | $136.192 | $194.800 |
| 15-02-005-00 | — | CICATRICES 3 Y MAS | $26.270 | $278.240 |
| 15-02-005-01 | — | CICATRICES 3 Y MAS (1 CIRUJANO) | $433.010 | $278.240 |
| 15-02-006-00 | — | HASTA 1% SUPERFICIE CORPORAL RECEPTORA | $26.270 | $59.260 |
| 15-02-007-00 | — | - HASTA 5% SUPERFICIE CORPORAL RECEPTORA | $26.270 | $97.440 |
| 15-02-008-00 | — | - HASTA 10% SUPERFICIE CORPORAL RECEPTOR | $118.180 | $180.860 |
| 15-02-009-00 | — | - POR CADA 10% ( O SU FRACCION) ADICIONA | $118.180 | $72.370 |
| 15-02-010-00 | — | - 51% Y MAS DE SUPERFICIE CORPORAL RECEP | $530.150 | $580.380 |
| 15-02-011-00 | — | PIEL TOTAL, CUALQUIER TAMANO (INCLUYE TR | $118.180 | $236.640 |
| 15-02-012-00 | — | - CARTILAGO (AURICULAR,COSTAL O SIMILARE | $26.270 | $250.400 |
| 15-02-013-00 | — | - OSEO (COSTAL, ILIACO, TIBIAL O SIMILAR | $118.180 | $287.760 |
| 15-02-014-00 | — | PLASTIAS EN Z HASTA 3 | $378.950 | $243.500 |
| 15-02-015-00 | — | PLASTIAS EN Z, 4 Y MAS | $118.180 | $230.860 |
| 15-02-016-00 | — | COLGAJOS COMPLEJOS (ABBE,MUSTARDA,CONV | $118.180 | $300.510 |
| 15-02-017-00 | — | - COLGAJOS LIBRES CON MICROANASTOMOSIS ( | $314.190 | $859.580 |
| 15-02-018-00 | — | COLGAJOS MUSCULARES O MUSCULOCUTANEOS | $118.180 | $408.860 |
| 15-02-019-00 | — | COLGAJOS OSTEOMUSCULOCUTANEOS | $118.180 | $622.980 |
| 15-02-020-00 | — | COLGAJOS SIMPLES DOS O MAS | $118.180 | $243.570 |
| 15-02-021-00 | — | COLGAJO SIMPLE UNICO | $118.180 | $222.480 |
| 15-02-022-00 | — | PARALISIS FACIAL, TRANSPLANTES MUSCULARE | $118.180 | $343.490 |
| 15-02-023-00 | — | RIDECTOMIA CERVICO-FACIAL, UN LADO | $118.180 | $263.980 |
| 15-02-024-00 | — | RIDECTOMIA FRONTAL | $118.180 | $230.740 |
| 15-02-025-00 | — | ALADAS O EN ASA, CORRECCION PLASTICA | $26.270 | $398.580 |
| 15-02-026-00 | — | LOBULO AURICULAR PARTIDO,CORRECCION PLAS | $97.630 | $62.740 |
| 15-02-026-01 | — | LOBULO AURICULAR REP BILATERAL | $97.630 | $62.740 |
| 15-02-027-00 | — | MALFORMACION CONGENITA COMPLEJA, CADA PL | $118.180 | $230.740 |
| 15-02-028-00 | — | CORRECCION NASAL PARCIAL (ALARES,ALARGAM | $118.180 | $230.860 |
| 15-02-029-00 | — | BLEFAROPLASTIA UNO O AMBOS PARPADOS INFE | $118.180 | $230.740 |
| 15-02-030-00 | — | BLEFAROPLASTIA UNO O AMBOS PARPADOS SUPE | $118.180 | $244.780 |
| 15-02-031-01 | — | BLEFAROPLASTIA SUP E INFERIOR | $118.180 | $230.740 |
| 15-02-032-00 | — | QUEILOPLASTIA PRIMARIA, UN LADO ( PROC. | $118.180 | $230.740 |
| 15-02-033-00 | — | CIERRE DE PALADAR DURO Y/O CIERRE DE COM | $118.180 | $224.770 |
| 15-02-034-00 | — | CIERRE MUCOSO VESTIBULO ORAL | $118.180 | $244.140 |
| 15-02-035-00 | — | PLASTIA DE VELO (CUALQUIER TECNICA) | $118.180 | $250.450 |
| 15-02-036-00 | — | CIERRE DE MACROSTOMIA, UN LADO | $118.180 | $230.860 |
| 15-02-037-00 | — | SINDROME DE TREACHER COLLINS, TRAT. QUIR | $118.180 | $410.160 |
| 15-02-038-00 | — | PLASTIA EN ZETA BILATERAL EN UN TIEMPO | $118.180 | $372.850 |
| 15-02-039-00 | — | ** - UNILATERAL | $118.180 | $265.900 |
| 15-02-040-00 | — | DISTOPLASIAS ORBITARIAS: MOVILIZACION UN | $314.190 | $686.540 |
| 15-02-041-00 | — | EXPANSION O RECONSTRUCCION DE UN MICRO-O | $314.190 | $686.540 |
| 15-02-042-00 | — | SINDROME DE APERT CROUZON O SIMILAR: AVA | $530.150 | $791.810 |
| 15-02-043-00 | — | SINDROME DE APERT CROUZON O SIMILAR: OST | $530.150 | $791.810 |
| 15-02-044-00 | — | CORRECCION TELECANTO | $118.180 | $263.980 |
| 15-02-045-00 | — | MOVILIZACION ORBITARIA EXTRACRANEANA | $314.190 | $686.540 |
| 15-02-046-00 | — | MOVILIZACION ORBITARIA INTRACRANEANA, TI | $530.150 | $791.810 |
| 15-02-047-00 | — | GINECOMASTIA, CORRECCION PLASTICA | $118.180 | $252.270 |
| 15-02-048-00 | — | MAMOPLASTIA DE AUMENTO | $118.180 | $230.860 |
| 15-02-048-01 | — | IMPLANTE MAMARIO | $314.190 | $230.860 |
| 15-02-049-00 | — | MAMOPLASTIA DE REDUCCION | $118.180 | $306.590 |
| 15-02-049-01 | — | REDUCCION MAMARIA | $314.190 | $306.590 |
| 15-02-050-00 | — | MASTOPEXIA C/S IMPLANTE DE PROTESIS (NO | $118.180 | $224.900 |
| 15-02-050-01 | — | MASTOPEXIA C/S IMPLANTE | $314.190 | $224.900 |
| 15-02-051-00 | — | RECONSTRUCCION AREOLA Y/O PEZON C/S PLAS | $118.180 | $250.400 |
| 15-02-052-00 | — | RECONSTRUCCION MAMARIA | $118.180 | $325.940 |
| 15-02-053-00 | — | LIPECTOMIA ABDOMINAL C/S TRANSPLANTE DE | $118.180 | $353.820 |
| 15-02-053-01 | — | ABDOMINOPLASTIA | $314.190 | $353.820 |
| 15-02-054-00 | — | CON RESECCION OSEA C/S COLGAJO DE ROTACI | $118.180 | $224.180 |
| 15-02-055-00 | — | CON RESECCION OSEA Y COLGAJOS MUSCULARES | $118.180 | $410.160 |
| 15-02-056-00 | — | SINDACTILIA, TRAT. QUIR. CADA ESPACIO CO | $118.180 | $236.640 |
| 15-02-057-00 | — | SINDACTILIA, TRAT. QUIR. CADA ESPACIO SI | $147.860 | $95.010 |
| 15-02-058-00 | — | POLIDACTILIA, EXTIRPACION Y PLASTIA UN L | $118.180 | $236.640 |
| 15-02-059-00 | — | LIPECTOMIA GLUTEA, UN LADO | $118.180 | $224.700 |
| 15-02-060-00 | — | LIPECTOMIA TROCANTEREA, UN LADO | $118.180 | $230.670 |
| 15-02-060-01 | — | IMPLANTE PANTORRILLAS | $118.180 | $230.670 |
| 15-02-060-02 | — | LIPECTOMIA TROCANTEREA (CP) | $118.180 | No disponible |
| 15-02-061-00 | — | ESCAROTOMIA HASTA 10 % SUPERFICIE CORPOR | $69.320 | $44.540 |
| 15-02-062-00 | — | ESCAROTOMIA POR CADA 10 % ADICIONAL (O S | $26.270 | $34.510 |
| 15-02-063-00 | — | ESCARECTOMIA HASTA 1 % SUPERFICIE CORPOR | $151.640 | $97.440 |
| 15-02-064-00 | — | ESCARECTOMIA HASTA 5 % SUPERFICIE CORPOR | $26.270 | $139.070 |
| 15-02-065-00 | — | ESCARECTOMIA HASTA 10% SUPERFICIE CORPO | $118.180 | $200.720 |
| 15-02-066-00 | — | ESCARECTOMIA POR CADA 10% ADICIONAL (O S | $118.180 | $111.340 |
| 15-02-120-00 | — | INFILTRACION BOTOX | No disponible | $352.000 |
| 15-02-121-00 | — | ADMINISTRACION BOTOX EN PAB.(TELETON) | $118.180 | $43.090 |
| 15-02-170-00 | — | LIPOSUCCION GENERAL | $118.180 | $86.110 |
| 15-02-171-00 | — | LIPOSUCCION UNA ZONA | $118.180 | $30.370 |
| 15-02-172-00 | — | LIPOSUCCION ABDOMEN,CADERAS,ESPALDA,MUSL | $118.180 | $86.110 |
| 15-02-173-00 | — | BICHATO PLASTIA | $118.180 | $60.770 |
| 15-02-180-00 | — | LIFTING | $314.190 | $116.500 |
| 15-02-181-00 | — | LIFTING PARCIAL | $118.180 | $60.770 |
| 16-01-109-00 | — | ESCLEROTERAPIA C/SESION | $79.680 | $32.000 |
| 16-01-110-00 | — | CURETAJE DE LESIONES VIRALES Y SIMILARES | $68.720 | $44.160 |
| 16-01-111-00 | — | APLICACION DE INMUNOMODULADORES HASTA 10 | $46.990 | $30.190 |
| 16-01-112-00 | — | FOTOTERAPIA UVB,UVA,LOCALIZADA ,POR SESI | $16.060 | $10.320 |
| 16-01-113-00 | — | FOTOTERAPIA UVB BANDA ANGOSTA Y UVA POR | $23.510 | $15.100 |
| 16-01-115-00 | — | IMPLANTES SUBCUTANEOS | $53.730 | $35.140 |
| 16-01-116-00 | — | CRIOTERAPIA HASTA 5 LESIONES | $46.240 | $29.710 |
| 16-01-117-00 | — | CRIOTERAPIA 6 A10 LESIONES | $72.340 | $46.480 |
| 16-01-118-00 | — | TUMOR MALIGNO POR CRIOCIRUGIA (CADA LESI | $130.800 | $84.050 |
| 16-01-119-00 | — | INYECCION INTRACUTANEA EN AREAS HASTA 9 | $48.210 | $30.980 |
| 16-01-120-00 | — | TRATAMIENTO ABRASIVO CUTANEO MECANICO | $91.630 | $58.880 |
| 16-01-121-00 | — | TRATAMIENTO ABRASIVO CUTANEO QUIMICO | $68.720 | $44.160 |
| 16-02-017-01 | — | IMPLANTE PELLET SUBCUTANEO | $21.090 | $100.000 |
| 16-02-201-00 | — | BIOPSIA DE PIEL Y/O MUCOSA POR CURETAJE | $121.210 | $77.890 |
| 16-02-202-00 | — | CABEZA ,CUELLO ,GENITALES HASTA 3 LESIO | $208.560 | $134.020 |
| 16-02-203-00 | — | RESTO DEL CUERPO HASTA 3 LESIONES | $142.600 | $91.630 |
| 16-02-204-00 | — | CABEZA CUELLO Y GENITALES DESDE 4 -6 LES | $417.200 | $268.080 |
| 16-02-205-00 | — | RESTO DEL CUERPO DESDE 4 A 6 LESIONES | $285.280 | $183.310 |
| 16-02-206-00 | — | EXTIRPACION DE LESIONES BENIGNAS POR SEC | $142.600 | $91.630 |
| 16-02-207-00 | — | TTO POR ELECTRO HEMANGIOMAS TELAGECTASIA | $142.600 | $91.630 |
| 16-02-211-00 | — | TU MALIGNO CABEZA CUELLO GENITALES | $434.480 | $279.180 |
| 16-02-211-01 | — | CABEZA CUELLO GENIT 1 CIRUJANO | $434.480 | $223.344 |
| 16-02-212-00 | — | RESTO DEL CUERPO | $347.630 | $223.380 |
| 16-02-212-01 | — | RESTO DEL CUERPO 1 CIRUJANO | $219.066 | $178.704 |
| 16-02-213-00 | — | CABEZA CUELLO GENITALES O MELANOMA CUALQ | $347.630 | $223.380 |
| 16-02-213-01 | — | CABEZA,CUELLO O GENITALES MELANOMA 1 CIR | $183.640 | $178.704 |
| 16-02-214-00 | — | RESTO DEL CUERPO | $267.480 | $171.870 |
| 16-02-214-01 | — | RESTO DEL CUERPO 1 CIRUJANO | $137.730 | $137.496 |
| 16-02-215-00 | — | TUMORES VASCULARES PROFUNDOS CARA,CUELLO | $421.880 | $271.090 |
| 16-02-215-01 | — | TUMORES VASCULARES PROFUNDOS CARA 1CIRUJ | $421.880 | $271.090 |
| 16-02-216-00 | — | TUMORES VASCULARES PROFUNDOS RESTO CUERP | $337.520 | $216.880 |
| 16-02-216-01 | — | TU VASCULARES PROFUNDOS RESTO CUERPO 1 C | $183.640 | $173.504 |
| 16-02-221-00 | — | HERIDA CORTANTE O CONTUSA COMPLICADA ,RE | $203.610 | $130.830 |
| 16-02-221-01 | — | SUTURA HERIDA CORTANTE O CONT COMPLICADA | $203.610 | $130.830 |
| 16-02-222-00 | — | HERIDA CORTANTE O CONTUSA NO COMPLICADA | $57.970 | $37.250 |
| 16-02-222-01 | — | SUTURA HERIDA CORTANTE O CONT NO COMPLIC | $57.970 | $37.250 |
| 16-02-223-00 | — | EXTIRPACION LESION BENIGNA CARA CUELLO G | $260.730 | $167.540 |
| 16-02-223-01 | — | CARA,CUELLO,CAB.GEN LESION BENIGNA 1 CIR | $260.730 | $134.032 |
| 16-02-223-02 | — | CABEZA CUELLO EXTIRPACION LESION 50% | $260.730 | $167.540 |
| 16-02-224-00 | — | RESTO DEL CUERPO | $217.100 | $139.500 |
| 16-02-224-01 | — | RESTO DEL CUERPO 1 CIRUJANO | $217.100 | $111.600 |
| 16-02-224-02 | — | RESTO DEL CUERPO EXTIRPACION LESION 50% | No disponible | $54.820 |
| 16-02-225-00 | — | VACIAMIENTO Y CURETAJE QUIRURGICO DE LES | $142.600 | $91.630 |
| 16-02-231-00 | — | ONISECTOMIA TOTAL O PARCIAL SIMPLE | $55.600 | $35.730 |
| 16-02-231-01 | — | ONISECTOMIA PARCIAL/TOTAL EN URGENCIAS | $55.600 | No disponible |
| 16-02-232-00 | — | CIRUGIA REPARADORA UNGEAL POR PROCESO IN | $173.800 | $111.680 |
| 16-02-233-00 | — | CORRECCION DEFECTO CONGENITO O TU UNGEAL | $278.060 | $178.670 |
| 16-02-240-00 | — | CURACION POR MEDICO QUEMADURA 5% | $38.600 | $24.800 |
| 16-02-241-00 | — | CURACION POR MEDICO QUEMADURA 5-10% | $75.520 | $48.530 |
| 16-02-242-00 | — | CURACION POR MEDICO QUEMADURA MAYOR 10% | $118.180 | $82.480 |
| 17-01-001-00 | — | E.C.G. DE REPOSO (INCLUYE MINIMO 12 DERI | $12.190 | $12.190 |
| 17-01-001-01 | — | ECG EN SERVICIO DE URGENCIA | $12.190 | $12.190 |
| 17-01-003-00 | — | ELECTROCARDIOGRAMA DE ESFUERZO | $49.340 | $49.340 |
| 17-01-004-00 | — | EN ADULTOS O NINOS | $66.370 | $66.370 |
| 17-01-006-00 | — | E.C.G. CONTINUO (TEST HOLTER O SIMILARES | $57.220 | $57.220 |
| 17-01-009-00 | — | MONITOREO CONTINUO DE PRESION ARTERIAL | $39.970 | $39.970 |
| 17-01-010-00 | — | SONDEO CARDIACO DERECHO C/S TERMODILUCIO | $71.230 | $71.230 |
| 17-01-011-00 | — | SONDEO CARDIACO IZQUIERDO Y DERECHO, EN | $89.120 | $89.120 |
| 17-01-011-01 | — | SONDEO CARDIACO DERECHO DETER. GASTO | $89.120 | No disponible |
| 17-01-012-00 | — | SONDEO CARDIACO IZQUIERDO: EN ADULTOS O | $75.630 | $75.630 |
| 17-01-013-00 | — | CATETERISMO EN RECIEN NACIDO POR ARTERIA | $31.940 | $31.940 |
| 17-01-014-00 | — | INSTALACION DE CATETER SWAN-GANZ O SIMIL | $80.050 | $80.050 |
| 17-01-014-03 | — | INSTALACION SIST PICCO FEM-BRAQUIAL ARTE | $80.050 | $80.050 |
| 17-01-015-00 | — | DOPPLER CON ERGOMETRIA (POR SESION) | $19.600 | $19.600 |
| 17-01-016-00 | — | DOPPLER SIMPLE DE VASOS PERIFERICOS (POR | $7.900 | $7.900 |
| 17-01-017-00 | — | PLETISMOGRAFIA EN REPOSO, ESFUERZO C/U ( | $25.460 | $25.460 |
| 17-01-018-00 | — | REGISTRO ECOARTERIAL O ECOVENOSO PERIFER | $35.230 | $35.230 |
| 17-01-019-00 | — | CINECORONARIOGRAFIA DERECHA Y/O IZQUIERD | $16.880 | $115.660 |
| 17-01-019-01 | — | CORONARIOGRAFIA ABORDAJE RADIAL | $16.880 | $115.660 |
| 17-01-019-02 | — | CORONARIOGRAFIA ABORDAJE FEMORAL | $16.880 | No disponible |
| 17-01-020-00 | — | VENTRICULOGRAFIA DERECHA (INCLUYE SONDEO | $71.230 | $71.230 |
| 17-01-021-00 | — | VENTRICULOGRAFIA IZQUIERDA (INCLUYE EL S | $16.880 | $80.050 |
| 17-01-022-00 | — | AORTOGRAFIA, EN ADULTOS O NINOS (A.C. 04 | $47.280 | $48.110 |
| 17-01-025-00 | — | CAVOGRAFIA (A.C. 04-02-035) | $43.680 | $43.680 |
| 17-01-026-00 | — | FLEBOGRAFIA DE CADA EXTREMIDAD (A.C.04-0 | $25.150 | $25.150 |
| 17-01-027-00 | — | FLEBOGRAFIA SELECTIVA | $43.680 | $43.680 |
| 17-01-030-00 | — | PUNCION EVACUADORA DE PERICARDIO, C/S TO | $26.750 | $26.750 |
| 17-01-030-01 | — | PERICARDIOCENTESIS | $26.750 | No disponible |
| 17-01-031-00 | — | ANGIOPLASTIA INTRALUMINAL CORONARIA PROC | $75.940 | $160.260 |
| 17-01-031-01 | — | ANGIOPLASTIA CORONARIA 1 VASO | $75.940 | $160.260 |
| 17-01-031-02 | — | ANGIOPLASTIA CORONARIA DE 2 VASOS | $75.940 | $160.260 |
| 17-01-031-03 | — | ANGIOPLASTIA CORONARIA DE TRONCO | $75.940 | No disponible |
| 17-01-032-00 | — | ANGIOPLASTIA INTRALUMINAL PERIFERICA PRO | $75.940 | $130.220 |
| 17-01-033-00 | — | BIOPSIA ENDOMIOCARDICA (PROC. COMPLETO) | $16.880 | $117.020 |
| 17-01-034-00 | — | CARDIOVERSION | $40.050 | $40.050 |
| 17-01-035-00 | — | COLOCACION MARCAPASO TRANSITORIO, SONDA | $56.380 | $56.380 |
| 17-01-037-00 | — | PUNCION SUBCLAVIA O YUGULAR CON COLOCACI | $31.940 | $31.940 |
| 17-01-038-00 | — | SEPTOSTOMIA DE RASHKIND | $16.880 | $178.030 |
| 17-01-039-00 | — | TROMBOLISIS ARTERIAL PERIFERICA | $133.540 | $133.540 |
| 17-01-039-01 | — | TROMBOLISIS EN SERVICIO URGENCIA | $133.540 | $133.540 |
| 17-01-040-00 | — | TROMBOLISIS INTRACORONARIA | $284.690 | $284.690 |
| 17-01-041-00 | — | VALVULOPLASTIA MITRAL (A.C. 04-02-033) | $16.880 | $342.500 |
| 17-01-041-01 | — | VALVULOPLASTIA MITRAL | $16.880 | No disponible |
| 17-01-042-00 | — | VALVULOPLASTIA AORTICA Y PULMONAR, (A.C. | $16.880 | $221.840 |
| 17-01-043-00 | — | ANGIOPLASTIA DE COARTACION AORTICA (A.C. | $16.880 | $221.840 |
| 17-01-045-00 | — | ECOCARDIOGRAMA DOPPLER COLOR ADULTOS | $121.650 | $121.650 |
| 17-01-045-01 | — | ECOCARDIO DOPPLER NIÑOS | $121.650 | $121.650 |
| 17-01-046-00 | — | ESTUDIO ELECTROFISIOLOGICO ENDOCARDIACO | $16.880 | $115.660 |
| 17-01-050-00 | — | ABLACION CON CORRIENTE CONTINUA O RADIOF | $16.880 | $115.660 |
| 17-01-051-00 | — | ABLACION CON CORRIENTE CONTINUA O CON RA | $16.880 | $184.940 |
| 17-01-055-00 | — | ECOCARDIOGRAMA DOPPLER COLOR TRANSESOFAG | $140.140 | $140.140 |
| 17-01-078-00 | — | INSTALACION CATETER CON RESERVORIO SUBCU | $440.380 | No disponible |
| 17-01-079-00 | — | RETIRO CATETER CON RESERVORIO SUBCUTANEO | $220.180 | $220.180 |
| 17-01-101-00 | — | INSTALACION PICCLINE | $80.050 | $80.050 |
| 17-01-102-00 | — | FISTULOGRAFIA (AV) | $63.570 | $63.570 |
| 17-01-114-00 | — | INSTALACION CVC EN SERVICIO DE URGENCIA | $80.050 | $80.050 |
| 17-01-117-00 | — | BIOPSIA CORE TORAXICA | $80.000 | $80.000 |
| 17-01-119-00 | — | CORONARIOGRAFIA DIAGNOSTICA COMPLEJA | $16.880 | $115.660 |
| 17-01-122-00 | — | AORTOGRAFIA | $16.880 | $48.110 |
| 17-01-123-00 | — | ARTERIOGRAFIA SELECTIVA EXTREMIDADES | $16.880 | $43.680 |
| 17-01-130-00 | — | PERICARDIOCENTESIS | $16.880 | $26.750 |
| 17-01-135-00 | — | INSTALACION SONDA MARCAPASO TRANSITORIO | $75.940 | $56.380 |
| 17-01-139-00 | — | TRATAMIENTO VASOESPASMO CEREBRAL | $131.220 | $131.220 |
| 17-01-140-00 | — | TROMBOLISIS INTRACEREBRAL URGENCIAS | $133.540 | No disponible |
| 17-01-161-00 | — | ARTERIOGRAFIA PULMONAR | $16.880 | $64.210 |
| 17-01-162-00 | — | ARTERIOGRAFIA RENAL | $16.880 | $64.210 |
| 17-01-163-00 | — | ARTERIOGRAFIA TRONCO CELIACO | $16.880 | $64.210 |
| 17-01-164-00 | — | ARTERIOGRAFIA ARTERIA GLUTEA | $16.880 | $64.210 |
| 17-01-165-00 | — | ARTERIOGRAFIA HIPOGASTRICA | $16.880 | $64.210 |
| 17-01-166-00 | — | ARTERIOGRAFIA HEPATICA | $16.880 | $64.210 |
| 17-01-167-00 | — | ARTERIOGRAFIA MESENTERICA | $16.880 | $64.210 |
| 17-01-168-00 | — | ARTERIOGRAFIA ARTERIA LUMBAR | $16.880 | $64.210 |
| 17-01-169-00 | — | ARTERIOGRAFIA ARTERIA VESICAL | $16.880 | $64.210 |
| 17-01-200-00 | — | INSTALACION CATETER ARTERIAL MPI | $80.000 | No disponible |
| 17-01-210-00 | — | MEDICION FLUJO RESERVA CORONARIO | $250.000 | $250.000 |
| 17-01-240-00 | — | ESCLEROTERAPIA VASCULAR BAJO FLUJO | $300.000 | $300.000 |
| 17-01-300-00 | — | ULTRASONIDO INTRACORONARIO | $250.000 | $250.000 |
| 17-01-400-00 | — | EXTRACCION CUERPO EXTRAÑO INTRACAVITARIO | $279.740 | $279.740 |
| 17-01-450-00 | — | INSTALACION BALON CONTRAPULSACION INTRA | $300.000 | $300.000 |
| 17-01-510-00 | — | ALCOHOLIZACION SEPTAL PARA MIOCARDIOPATI | $1.300.000 | $1.300.000 |
| 17-03-001-00 | — | EMBOLECTOMIA Y/O TROMBECTOMIA, UNILATERA | $201.890 | $250.450 |
| 17-03-002-00 | — | FISTULA ARTERIOVENOSA CONGENITA O TRAUMA | $201.890 | $446.320 |
| 17-03-003-00 | — | FISTULA ARTERIOVENOSA (DE BRESCIA O SIMI | $75.940 | $607.860 |
| 17-03-005-00 | — | REPAR. QUIR. DE VASOS ARTERIALES Y/O VEN | $201.890 | $572.960 |
| 17-03-006-00 | — | REPARACION QUIR. DE VASOS ARTERIALES Y/O | $75.940 | $376.940 |
| 17-03-007-00 | — | ANEURISMA AORTICO ABDOMINAL TRAT. QUIR. | $340.660 | $904.060 |
| 17-03-008-00 | — | ANEURISMAS PERIFERICOS, TRAT. QUIR. | $75.940 | $462.480 |
| 17-03-009-00 | — | ANEURISMAS TORACO-ABDOMINAL TRAT. QUIR. | $340.660 | $1.173.740 |
| 17-03-010-00 | — | PUENTES AORTO-BIFEMORAL | $201.890 | $793.840 |
| 17-03-011-00 | — | PUENTES AORTO-UNIFEMORAL | $201.890 | $607.300 |
| 17-03-012-00 | — | PUENTES AORTO-VISCERAL (RENAL, MESENTERI | $340.660 | $710.500 |
| 17-03-013-00 | — | PUENTES AORTO-ILIACO | $340.660 | $676.930 |
| 17-03-014-00 | — | ENDARTERECTOMIA CAROTIDEA, SUBCLAVIA, VE | $201.890 | $642.690 |
| 17-03-015-00 | — | ENDARTERECTOMIA FEMORAL COMUN, SUPERFICI | $201.890 | $392.940 |
| 17-03-016-00 | — | ENDARTERECTOMIA RENAL, C/S INJERTO (PROC | $201.890 | $461.260 |
| 17-03-017-00 | — | FEMORO-TIBIAL O DISTALES | $201.890 | $607.300 |
| 17-03-018-00 | — | FEMORO-POPLITEO | $201.890 | $607.300 |
| 17-03-019-00 | — | LIGADURA TRONCOS ARTERIALES, (PROC. AUT. | $75.940 | $237.820 |
| 17-03-020-00 | — | OTRAS DERIVACIONES: FEMORO-FEMORAL, AXIL | $201.890 | $491.680 |
| 17-03-021-00 | — | ANASTOMOSIS PORTOCAVA U OTRAS PORTOSISTE | $340.660 | $808.060 |
| 17-03-022-00 | — | ANASTOMOSIS VENOSAS INTRAABDOMINALES | $340.660 | $607.300 |
| 17-03-023-00 | — | DENUDACION VENOSA (PROC. AUT.) | $95.010 | $95.010 |
| 17-03-024-00 | — | DERIVACIONES VENOSAS DE EXTREMIDADES | $201.890 | $433.650 |
| 17-03-025-00 | — | IMPLANTE FILTROS VENOSOS | $75.940 | $488.140 |
| 17-03-026-00 | — | LIGADURA CAYADO SAFENA INTERNA, UNILATER | $75.940 | $230.860 |
| 17-03-027-00 | — | LIGADURA OTROS TRONCOS VENOSOS (POPLITEO | $75.940 | $230.670 |
| 17-03-028-00 | — | LIGADURA VENA CAVA INFERIOR | $75.940 | $444.560 |
| 17-03-029-00 | — | RESECCION CUTANEO-APONEUROTICA UNILATERA | $75.940 | $268.770 |
| 17-03-030-00 | — | SAFENECTOMIA INTERNA Y/O EXTERNA, UNILAT | $75.940 | $230.860 |
| 17-03-031-00 | — | TROMBECTOMIA DE VENAS PROFUNDAS | $75.940 | $243.570 |
| 17-03-032-00 | — | ANASTOMOSIS LINFOVENOSAS | $75.940 | $352.320 |
| 17-03-033-00 | — | LINFEDEMA, TRAT. QUIR. UNA EXTREMIDAD | $75.940 | $486.320 |
| 17-03-034-00 | — | ADENITIS, TRAT. QUIR., | $16.880 | $92.100 |
| 17-03-035-00 | — | BIOPSIA QUIR. GANGLIONAR (CUALQUIER REGI | $192.130 | $192.130 |
| 17-03-035-01 | — | BIOPSIA QX GANGLIONAR HM | $192.130 | $192.130 |
| 17-03-036-00 | — | AXILO-SUPRACLAVICULAR | $201.890 | $527.790 |
| 17-03-037-00 | — | CERVICO-TORACICA | $201.890 | $436.290 |
| 17-03-038-00 | — | ILEOINGUINAL | $201.890 | $540.540 |
| 17-03-039-00 | — | INGUINOESCROTALES | $201.890 | $447.390 |
| 17-03-040-00 | — | LUMBO-AORTICOS | $201.890 | $655.490 |
| 17-03-041-00 | — | MEDIASTINICOS | $201.890 | $624.980 |
| 17-03-042-00 | — | POPLITEOS | $75.940 | $340.780 |
| 17-03-043-00 | — | RADICAL CLASICA O MODIFICADA DE CUELLO | $75.940 | $474.700 |
| 17-03-044-00 | — | YUGULAR SIMPLE | $75.940 | $237.620 |
| 17-03-045-00 | — | CERVICO-TORACICA | $201.890 | $500.750 |
| 17-03-045-01 | — | CERVICO TORAXICA POR VIDEOTORACOSCOPIA | $201.890 | $500.750 |
| 17-03-046-00 | — | LUMBAR | $201.890 | $379.680 |
| 17-03-047-00 | — | ANASTOMOSIS VASCULARES SISTEMICOPULMONAR | $340.660 | $763.580 |
| 17-03-048-00 | — | CAMBIO DE GENERADOR DE MARCAPASO, SIN CA | $75.940 | $250.450 |
| 17-03-049-00 | — | COARTACION AORTICA INFANTIL (PREDUCTAL) | $340.660 | $717.490 |
| 17-03-050-00 | — | COARTACION AORTICA, TRAT. QUIR. | $340.660 | $763.580 |
| 17-03-051-00 | — | CONDUCTO ARTERIOSO PERSISTENTE, TRAT. QU | $201.890 | $726.530 |
| 17-03-052-00 | — | FISTULA CORONARIA, TRAT. QUIR. | $201.890 | $686.540 |
| 17-03-053-00 | — | IMPLANTACION DE MARCAPASO C/ELECTROD. IN | $75.940 | $279.550 |
| 17-03-053-01 | — | IMPLANTE MARCAPASO CON RESINCRONISACION | $75.940 | No disponible |
| 17-03-054-00 | — | OPERACION SOBRE ANILLOS VALVULARES O VAS | $201.890 | $558.540 |
| 17-03-055-00 | — | OPERACIONES SOBRE ARTERIA PULMONAR, CONS | $201.890 | $527.790 |
| 17-03-056-00 | — | PERICARDIECTOMIA Y/O EXTIRP. DE QUISTES | $201.890 | $796.400 |
| 17-03-057-00 | — | PERICARDIORRAFIA O MIOPERICARDIORRAFIA E | $201.890 | $686.540 |
| 17-03-058-00 | — | PERICARDIOTOMIA | $201.890 | $414.510 |
| 17-03-059-00 | — | SINEQUIAS PERICARDICAS, TRAT.QUIR. ( PRO | $201.890 | $549.700 |
| 17-03-061-00 | — | DE COMPLEJIDAD MAYOR: INCLUYE REEMPLAZ | $340.660 | $1.503.920 |
| 17-03-062-00 | — | DE COMPLEJIDAD MEDIANA: INCLUYE COMUNI | $340.660 | $1.084.620 |
| 17-03-063-00 | — | DE COMPLEJIDAD MENOR:INCLUYE COMUNICACI | $340.660 | $862.620 |
| 17-03-066-00 | — | INSTALACION CATETER VENOSO TUNELIZADO | $432.720 | $440.380 |
| 17-03-074-00 | — | RETIRO CATETER VENOSO LARGA DURACION TUN | $286.234 | $220.180 |
| 17-03-101-00 | — | EMBOLIZACION VASOS PERIFERICOS | $75.940 | $250.450 |
| 17-03-109-00 | — | ENDOPROTESIS AORTICA TORAXICA-ABDOMINAL | $1.300.000 | $1.300.000 |
| 17-03-114-00 | — | TROMBECTOMIA MECANICA CEREBRAL | $201.890 | $642.690 |
| 17-03-115-00 | — | ANGIOPLASTIA CEREBRAL | $340.660 | $642.690 |
| 17-03-116-00 | — | ANGIOPLASTIA CAROTIDEA | $340.660 | $642.690 |
| 17-03-124-00 | — | ANGIOPLASTIA FARMACOLOGICA | $631.500 | $631.500 |
| 17-03-145-00 | — | CIRUGIA HIPERHIDROSIS | $340.660 | $213.200 |
| 17-03-148-00 | — | CAMBIO GENERADOR MARCAPASO | $75.940 | $250.450 |
| 17-03-153-01 | — | IMPLANTE MARCAPASO UNICAMERAL | $201.890 | $279.550 |
| 17-03-153-02 | — | IMPLANTE MARCAPASO BICAMERAL | $201.890 | $279.550 |
| 17-03-155-00 | — | MARCAPASO ESTIMULACION FISIOLOGICA | $75.940 | $279.550 |
| 17-03-156-00 | — | ESTIMULACION FISIOLOGICA RAMA IZQUIERDA | $300.000 | $300.000 |
| 17-03-172-00 | — | IMPLANTE DESFRIB.RESINCRONIZADOR VVI | $600.000 | $600.000 |
| 17-03-173-00 | — | IMPLANTE DESFRIB.RESINCRONIZADOR DDD | $600.000 | $600.000 |
| 17-03-177-00 | — | EXTRACCION MARCAPASO | $219.752 | $219.752 |
| 17-03-910-00 | — | REPOSICIONAMIENTO DE ELECTRODO | $450.000 | $450.000 |
| 17-04-001-00 | — | CIRUGIA DEL OPERCULO TORACICO | $201.890 | $353.090 |
| 17-04-002-00 | — | CIRUGIA TORAX ABIERTO TRAUMATICO Y/O FIJ | $201.890 | $597.950 |
| 17-04-003-00 | — | FENESTRACION O TORACOPLASTIA | $201.890 | $358.770 |
| 17-04-004-00 | — | REPARACION PECTUM EXCAVATUM O CARINATUM, | $201.890 | $369.970 |
| 17-04-005-00 | — | RESECCION DE COSTILLAS Y/O PARED COSTAL | $75.940 | $272.800 |
| 17-04-006-00 | — | RESECCION DE PARED COSTAL C/PLASTIA (TOR | $75.940 | $340.780 |
| 17-04-007-00 | — | TORACOFRENOLAPARATOMIA EXPLORADORA C/S | $201.890 | $474.080 |
| 17-04-008-00 | — | TORACOFRENOTOMIA EXPLORADORA | $201.890 | $381.820 |
| 17-04-009-00 | — | TORACOTOMIA EXPLORADORA, C/S BIOPSIA, C/ | $201.890 | $322.720 |
| 17-04-009-01 | — | VIDEOTORACOSCOPIA POR LAPARASCOPIA | $201.890 | $322.720 |
| 17-04-010-00 | — | TORACOTOMIA MINIMA C/S RESECCION COSTAL, | $75.940 | $236.640 |
| 17-04-011-00 | — | MEDIASTINOTOMIA EXPLORADORA ANT.O POST.C | $75.940 | $252.190 |
| 17-04-012-00 | — | VIA CERVICAL | $75.940 | $230.860 |
| 17-04-013-00 | — | VIA TORACICA | $75.940 | $347.060 |
| 17-04-014-00 | — | TIMECTOMIA VIA CERVICAL | $75.940 | $340.780 |
| 17-04-015-00 | — | TIMECTOMIA VIA TORACICA MEDIOESTERNAL | $75.940 | $417.920 |
| 17-04-016-00 | — | CONDUCTO TORACICO, LIGADURA QUIRURGICA | $201.890 | $393.630 |
| 17-04-017-00 | — | TUMORES O QUISTES DE MEDIASTINO (ANTERIO | $201.890 | $680.540 |
| 17-04-018-00 | — | CIRUGIA DEL DIAFRAGMA CON CIRUGIA DE VIS | $201.890 | $501.100 |
| 17-04-019-00 | — | HERIDAS TRAUMATICAS, TRAT. QUIR. | $201.890 | $330.540 |
| 17-04-020-00 | — | HERNIOPLASTIA DIAFRAGMATICA POR VIA TORA | $201.890 | $404.060 |
| 17-04-021-00 | — | HERNIOPLASTIA DIAFRAGMATICA POR VIA TORA | $201.890 | $356.210 |
| 17-04-022-00 | — | TUMORES, MALFORMACIONES O QUISTES DEL DI | $201.890 | $381.820 |
| 17-04-023-00 | — | CUERPO EXTRANO PLEURAL, EXTRAC. QUIR. | $201.890 | $322.720 |
| 17-04-024-00 | — | DECORTICACION PLEUROPULMONAR (PLEURECTOM | $201.890 | $344.910 |
| 17-04-024-01 | — | DECORTICACION PLEUROPULMONAR LAPAROSCOPI | $340.660 | $344.910 |
| 17-04-025-00 | — | PLEURODESIS POR PLEUROTOMIA | $75.940 | $135.580 |
| 17-04-025-01 | — | PLEURODESIS | $128.000 | $128.000 |
| 17-04-026-00 | — | PLEURODESIS POR TORACOTOMIA | $201.890 | $322.720 |
| 17-04-026-01 | — | PLEURODESIS POR TORACOSCOPIA | $201.890 | $322.720 |
| 17-04-027-00 | — | PLEUROTOMIA UNICA O DOBLE C/S BIOPSIA CO | $16.880 | $97.440 |
| 17-04-027-01 | — | PLEUROTOMIA EN URGENCIAS | $97.440 | $97.440 |
| 17-04-028-00 | — | TUMORES PLEURALES, TRAT. QUIR. | $201.890 | $336.210 |
| 17-04-029-00 | — | BRONCOTOMIA O TRAQUEOBRONCOTOMIA EXPLORA | $201.890 | $381.820 |
| 17-04-030-00 | — | CIRUGIA RUPTURA TRAQUEOBRONQUIAL O TRATA | $201.890 | $732.700 |
| 17-04-031-00 | — | PLASTIA DE TRAQUEA Y/O BRONQUIOS C/S RES | $201.890 | $763.580 |
| 17-04-032-00 | — | TRATAMIENTO QUIRURGICO FISTULA BRONQUIAL | $201.890 | $502.220 |
| 17-04-033-00 | — | TUMORES TRAQUEALES, EXTIRPACION | $201.890 | $808.060 |
| 17-04-034-00 | — | ABSCESO PULMONAR, DRENAJE POR TORACOTOMI | $201.890 | $304.980 |
| 17-04-035-00 | — | BIOPSIA PULMONAR POR TORACOTOMIA | $201.890 | $314.400 |
| 17-04-036-00 | — | BULAS, TRAT. QUIR. | $201.890 | $331.040 |
| 17-04-036-01 | — | BULAS TTO POR VIDEOTORACOSCOPIA | $201.890 | $331.040 |
| 17-04-037-00 | — | CIRUGIA DE QUISTE HIDATIDICO SIN RESECCI | $201.890 | $607.300 |
| 17-04-038-00 | — | CUERPO EXTRANO INTRAPULMONAR, EXTIRP. QU | $201.890 | $369.070 |
| 17-04-039-00 | — | HERIDAS DE PULMON, TRAT. QUIR. (PROC. AU | $75.940 | $317.700 |
| 17-04-040-00 | — | LOBECTOMIA O BILOBECTOMIA | $201.890 | $659.260 |
| 17-04-041-00 | — | METASTASIS BILATERAL, TRAT. QUIR. POR ES | $201.890 | $622.980 |
| 17-04-042-00 | — | METASTASIS UNILATERAL | $201.890 | $420.430 |
| 17-04-043-00 | — | NEUMONECTOMIA C/S RESECCION DE PARED COS | $201.890 | $787.230 |
| 17-04-045-00 | — | QUISTECTOMIA SIMPLE | $201.890 | $420.430 |
| 17-04-046-00 | — | RESECCIONES SEGMENTARIAS | $201.890 | $572.960 |
| 17-04-046-01 | — | RESECCION SEGMENTARIAS POR VIDEOTORACOSC | $340.660 | $572.960 |
| 17-04-047-00 | — | VIA CERVICAL | $75.940 | $238.300 |
| 17-04-048-00 | — | VIA TORACICA | $201.890 | $381.820 |
| 17-04-049-00 | — | ESOFAGOSTOMIA CERVICAL (PROC. AUT.) | $75.940 | $252.190 |
| 17-04-050-00 | — | VIA CERVICAL | $201.890 | $230.740 |
| 17-04-051-00 | — | VIA TORACICA | $201.890 | $371.970 |
| 17-04-052-00 | — | VIA CERVICAL | $75.940 | $230.740 |
| 17-04-053-00 | — | VIA TORACICA | $75.940 | $404.060 |
| 17-04-054-00 | — | ACHALASIA, TRAT. QUIR. | $75.940 | $488.140 |
| 17-04-055-00 | — | ATRESIA ESOFAGICA, TRAT. QUIR. | $340.660 | $680.540 |
| 17-04-056-00 | — | ESOFAGECTOMIA CON RESTITUCION DEL TRANSI | $340.660 | $889.410 |
| 17-04-057-00 | — | ESOFAGECTOMIA TOTAL CON ESOFAGOSTOMIA, G | $340.660 | $655.920 |
| 17-04-058-00 | — | ESOFAGOGASTRECTOMIA PROXIMAL | $340.660 | $735.380 |
| 17-04-059-00 | — | PROTESIS O TUBO ENDOESOFAGICO, COLOCACIO | $75.940 | $353.920 |
| 17-04-060-00 | — | RECONSTITUCION DE TRANSITO EN SEGUNDO TI | $201.890 | $479.170 |
| 17-04-061-00 | — | SUTURA HERIDA O PERFORACION ESOFAGO CERV | $201.890 | $502.220 |
| 17-04-062-00 | — | SUTURA HERIDA O PERFORACION ESOFAGO TORA | $201.890 | $607.300 |
| 17-04-063-00 | — | VARICES, LIGADURA DIRECTA | $75.940 | $444.560 |
| 17-04-064-00 | — | FRENOPARALISIS TRAT. QUIR. | $201.890 | $510.780 |
| 17-07-001-00 | — | ESPIROMETRIA- BASAL | $11.940 | $11.940 |
| 17-07-002-00 | — | ESPIROMETRIA BASAL Y CON BRONCODILATADOR | $19.920 | $19.920 |
| 17-07-003-00 | — | PROVOCACION CON ANTIGENO (INCLUYE EL ANT | $35.890 | $35.890 |
| 17-07-004-00 | — | PROVOCACION CON EJERCICIO, TEST DE | $30.530 | $30.530 |
| 17-07-005-00 | — | PROVOCACION CON HISTAMINA (PD 20),TEST D | $33.140 | $33.140 |
| 17-07-007-00 | — | ANALISIS DE GAS ESPIRADO | $13.710 | $13.710 |
| 17-07-008-00 | — | CAPACIDAD DE DIFUSION, ESTUDIO DE | $21.950 | $21.950 |
| 17-07-009-00 | — | CAPACIDAD FISICA DEL TRABAJO | $29.940 | $29.940 |
| 17-07-010-00 | — | CURVA DE LAVADO DE NITROGENO (N) | $29.520 | $29.520 |
| 17-07-011-00 | — | CURVA DE RELAJACION FLUJOVOLUMEN BASAL | $15.100 | $15.100 |
| 17-07-012-00 | — | DISTENSIBILIDAD PULMONAR, ("COMPLIANCE") | $26.290 | $26.290 |
| 17-07-013-00 | — | MEDICION DE PRESION DE OCLUSION | $22.720 | $22.720 |
| 17-07-014-00 | — | MEDICION DE PRESION INSPIRATORIA MAXIMA | $9.470 | $9.470 |
| 17-07-015-00 | — | MEDICION DE PRESION TRANS-DIAFRAGMATICA | $25.460 | $25.460 |
| 17-07-016-00 | — | REGISTRO FLUJOMETRICO, POR SEMANA | $9.950 | $9.950 |
| 17-07-017-00 | — | RESPUESTA RESPIRATORIA AL CO2 | $48.140 | $48.140 |
| 17-07-018-00 | — | TIEMPO DE TOLERANCIA A LA FATIGA RESPIRA | $13.150 | $13.150 |
| 17-07-019-00 | — | VENTILACION ALVEOLAR, ESTUDIO DE (INCLUY | $76.620 | $76.620 |
| 17-07-020-00 | — | VOLUMEN RESIDUAL, ESTUDIO DE MEDICION DE | $42.100 | $42.100 |
| 17-07-021-00 | — | LARIGOTRAQUEOSCOPIA CON FIBROSCOPIO | $75.860 | $75.860 |
| 17-07-022-00 | — | LARIGOTRAQUEOSCOPIA CON TUBO RIGIDO | $16.880 | $30.420 |
| 17-07-023-00 | — | MEDIASTINOSCOPIA C/S BIOPSIA | $16.880 | $69.600 |
| 17-07-024-00 | — | PLEUROSCOPIA (TORACOSCOPIA) C/S BIOPSIA | $16.880 | $42.190 |
| 17-07-025-00 | — | PROCEDIM.PARA DETERMINAR GASOMETRIA ARTE | $9.700 | $9.700 |
| 17-07-026-00 | — | PROCEDIM.PARA DETERMINAR GASOMETRIA ARTE | $6.530 | $6.530 |
| 17-07-027-00 | — | BRONCOASPIRACION, C/S LAVADO Y/O COLOCAC | $16.880 | $22.690 |
| 17-07-027-01 | — | BRONCO ASPIRACION C/LAVADO PAB | $22.690 | $22.690 |
| 17-07-029-00 | — | TORACOCENTESIS EVACUADORA,C/S TOMA DE MU | $25.390 | $25.390 |
| 17-07-030-00 | — | AEROSOLTERAPIA CON AIRE COMPRIMIDO Y OXI | $3.180 | $3.180 |
| 17-07-032-00 | — | BIOPSIA PLEURAL (CON AGUJA) | $28.770 | $28.770 |
| 17-07-033-00 | — | BIOPSIA PULMONAR (CON AGUJA) NO INCLUYE | $29.540 | $29.540 |
| 17-07-034-00 | — | CUERPO EXTRANO DE BRONQUIO, EXTRACCION P | $16.880 | $102.590 |
| 17-07-035-00 | — | INMUNOTERAPIA POR BCG | $12.450 | $12.450 |
| 17-07-036-00 | — | INMUNOTERAPIA POR SESION (INCLUYE EL TRA | $13.630 | $13.630 |
| 17-07-037-00 | — | INTUBACION TRAQUEAL (PROC. AUT.) | $16.880 | $21.060 |
| 17-07-038-00 | — | MONITOREO O ESTUDIO DE APNEA DURANTE EL | $44.450 | $44.450 |
| 17-07-051-00 | — | CURVA DOSIS RESPUESTA A BRONCODILATADORE | $27.950 | $27.950 |
| 17-07-052-00 | — | SATUROMETRIA NOCTURNA DEL SUEÑO | $28.960 | $28.960 |
| 17-07-053-00 | — | TITULACION AUTOMATICA CPAP | $38.110 | $38.110 |
| 17-07-054-00 | — | SATURACION DE O2 EN REPOSO Y/O EJERCICIO | $6.060 | $6.060 |
| 17-07-055-00 | — | SATURACION DE O2 EN REPOSO Y/O EJERCICIO | $6.780 | $6.780 |
| 17-07-102-00 | — | TEST DE MARCHA | $12.000 | $12.000 |
| 17-07-110-00 | — | FRACCION EXPIRADA OXIDO NITRICO (FENO) | $43.190 | $43.190 |
| 17-07-129-00 | — | INSTALACION DRENAJE PLEURAL | $100.000 | No disponible |
| 18-01-001-00 | — | GASTRODUODENOSCOPIA (INCLUYE ESOFAGOSCOP | $101.570 | $65.260 |
| 18-01-002-00 | — | ESOFAGOSCOPIA | $39.490 | $25.380 |
| 18-01-003-00 | — | ENTEROSCOPIA | $124.000 | $79.680 |
| 18-01-004-00 | — | ANO-RECTO-SIGMOIDOSCOPIA EN ADULTOS | $38.350 | $24.640 |
| 18-01-006-00 | — | COLONOSCOPIA LARGA (INCLUYE SIGMOIDOSCOP | $137.600 | $88.420 |
| 18-01-007-00 | — | SIGMOIDOSCOPIA Y COLONOSCOPIA IZQUIERDA | $114.790 | $73.760 |
| 18-01-008-00 | — | - COLEDOCOSCOPIA INTRAOPERATORIA C/S EXT | $20.120 | $12.930 |
| 18-01-009-00 | — | - PERITONEOSCOPIA TRANSPARIETAL (INCLUYE | $76.270 | $49.010 |
| 18-01-011-00 | — | MANOMETRIA ESOFAGICA | $67.230 | $43.200 |
| 18-01-012-00 | — | - REFLUJO ACIDO, TEST DE (GROSSMAN O SIM | $46.340 | $29.780 |
| 18-01-015-00 | — | BIOPSIA DE INTESTINO DELGADO, POR CAPSUL | $57.420 | $36.900 |
| 18-01-016-00 | — | PUNCION BIOPSIA TRANSPARIETAL DE ORGAN | $58.240 | $37.420 |
| 18-01-018-00 | — | COLANGIOPANCREATOGRAFIA RETROGRADA, POR | $167.950 | $107.920 |
| 18-01-019-00 | — | DRENAJE DE LA VIA BILIAR TRANSHEPATICA Y | $76.270 | $49.010 |
| 18-01-020-00 | — | FISTULOGRAFIA (A.C. 04-02-009) | $24.280 | $15.600 |
| 18-01-021-00 | — | NEUMOPERITONEO POR PUNCION TRANSPARIETAL | $24.280 | $15.600 |
| 18-01-022-00 | — | INSTALACION SONDA DE SENGSTAKEN | $24.250 | $15.580 |
| 18-01-023-00 | — | INTUBACION CON SONDA GASTRICA | $9.240 | $5.940 |
| 18-01-023-01 | — | INSTALACION SONDA GASTRICA (URGENCIAS | $9.240 | $5.940 |
| 18-01-024-00 | — | INTUBACION CON SONDA DE MILLER-ABBOT O D | $10.160 | $6.530 |
| 18-01-025-00 | — | DILATACION ESSOFAGICA POR BALON NEUMATIC | $48.410 | $31.100 |
| 18-01-026-00 | — | DILATACION ESOFAGICA POR BUJIA DE HG (HU | $20.090 | $12.910 |
| 18-01-027-00 | — | INSTALACION PROTESIS PLASTICA EN VIA BIL | $166.180 | $106.780 |
| 18-01-028-00 | — | CUERPO EXTRANO DE ESOFAGO Y/O ESTOMAGO, | $121.260 | $77.920 |
| 18-01-028-02 | — | CUERPO EXTRAÑO EXTRACCION ENDOSCOPICA | $121.260 | $77.920 |
| 18-01-028-03 | — | CUERPO EXTRAÑO EXTRACCION ENDOSCOP PAB | $121.260 | $77.920 |
| 18-01-029-00 | — | DEVOLVULACION DEL SIGMOIDES POR ENDOSCOP | $69.250 | $44.500 |
| 18-01-030-00 | — | DILATACION ANO-RECTAL, POR SESION | $10.310 | $6.620 |
| 18-01-031-00 | — | POLIPECTOMIA ENDOSCOPICA ALTA | $132.000 | $84.820 |
| 18-01-031-01 | — | MUCOSECTOMIA | $132.000 | $84.820 |
| 18-01-032-00 | — | ESCLEROTERAPIA DE HEMORROIDES, CUALQUIER | $60.380 | $38.800 |
| 18-01-033-00 | — | INYECTOTERAPIA HEMOSTATICA ,HEMOSTASIA | $177.240 | $113.890 |
| 18-01-035-00 | — | LIGADURA HEMORROIDES | $76.640 | $49.250 |
| 18-01-036-00 | — | PAPILOTOMIA ENDOSCOPICA C/S EXTRACCION D | $78.860 | $50.670 |
| 18-01-037-00 | — | UREASA, TEST DE (PARA HELICOBACTER PYLOR | $16.580 | $10.660 |
| 18-01-038-00 | — | PUNCION ORG INTRAABDOMINAL ,HEPATICA | $63.200 | $40.610 |
| 18-01-038-01 | — | PUNCION TORAXICA | $63.200 | $40.610 |
| 18-01-041-00 | — | PUNCION EVACUADORA DE LIQUIDO ASCITICO, | $55.400 | $35.600 |
| 18-01-042-00 | — | VACIAMIENTO MANUAL DE FECALOMA | $89.990 | $57.820 |
| 18-01-043-00 | — | MANOMETRIA ANORRECTAL | $65.760 | $42.260 |
| 18-01-045-00 | — | POLIPECTOMIA ENDOSCOPICA BAJA | $228.930 | $147.100 |
| 18-01-100-00 | — | TEST INTOLERANCIA LACTOSA | $52.000 | $52.000 |
| 18-01-116-00 | — | BIOPSIA CORE ABDOMINAL | $186.750 | $120.000 |
| 18-01-117-00 | — | BIOPSIA CORE HEPATICA | $186.750 | $120.000 |
| 18-01-118-00 | — | COLANGIOGRAFIA RETROGRADA PERCUTANEA | $165.040 | No disponible |
| 18-01-119-00 | — | DRENAJE BILIAR | $74.950 | $49.010 |
| 18-01-120-00 | — | BIOPSIA CORE PARTES BLANDAS | $186.750 | $120.000 |
| 18-01-127-00 | — | STENT VIA BILIAR | $163.990 | No disponible |
| 18-02-001-00 | — | HERNIA ABDOMINAL POR LAPAROTOMIA | $118.180 | $551.420 |
| 18-02-001-01 | — | HERNIA DIAFRAGMATICA VIA LAPAROSCOPICA | $314.190 | $551.420 |
| 18-02-004-00 | — | LAPAROTOMIA EXPLORADORA, C/S LIBERACION | $118.180 | $250.670 |
| 18-02-004-01 | — | LAPAROTOMIA EXPLORADORA POR LAPAROSCOPIA | $314.190 | $250.670 |
| 18-02-005-00 | — | ONFALOCELE (HASTA 5 CMS.) TRAT. QUIR. | $118.180 | $259.040 |
| 18-02-006-00 | — | ONFALOCELE (MAS DE 5 CMS.) TRAT. QUIR. | $118.180 | $315.200 |
| 18-02-007-00 | — | PERITONITIS DIFUSA AGUDA, TRAT. QUIR. (P | $118.180 | $353.920 |
| 18-02-007-01 | — | PERITONITIS POR LAPAROSCOPIA | $314.190 | $353.920 |
| 18-02-008-00 | — | TUMOR Y/O QUISTE PERITONEAL (PARIETAL) | $118.180 | $251.280 |
| 18-02-009-00 | — | TUMOR Y/O QUISTE RETROPERITONEAL | $118.180 | $421.300 |
| 18-02-010-00 | — | ANTRECTOMIA Y VAGOTOMIA TRONCULAR O SELE | $314.190 | $489.260 |
| 18-02-011-00 | — | DESGASTRECTOMIA Y NEOANASTOMOSIS, C/S VA | $314.190 | $614.720 |
| 18-02-012-00 | — | GASTROENTEROANASTOMOSIS, CUALQUIER TECNI | $118.180 | $414.510 |
| 18-02-013-00 | — | GASTROSQUISIS | $314.190 | $429.280 |
| 18-02-014-00 | — | GASTROTOMIA Y/O GASTROSTOMIA (PROC. AUT. | $389.760 | $250.450 |
| 18-02-015-00 | — | PERFORACION GASTRICA AGUDA, TRAT. QUIR. | $118.180 | $363.070 |
| 18-02-015-01 | — | PERFORACION GASTRICA POR LAPAROSCOPIA | $471.991 | $363.070 |
| 18-02-016-00 | — | PILOROPLASTIA (PROC.AUT.) | $118.180 | $283.970 |
| 18-02-017-00 | — | GASTRECTOMIA SUBTOTAL CON DISECCION GANG | $314.190 | $595.860 |
| 18-02-018-00 | — | GASTRECTOMIA SUBTOTAL SIN DISECCION GANG | $314.190 | $503.060 |
| 18-02-019-00 | — | DUMPING Y/O SINDROME ASA AFERENTE, TRAT. | $314.190 | $566.300 |
| 18-02-022-00 | — | GASTRECTOMIA TOTAL | $314.190 | $706.560 |
| 18-02-023-00 | — | GASTRECTOMIA TOTAL O SUBTOTAL AMPLIADA ( | $530.150 | $817.440 |
| 18-02-024-00 | — | GASTROPEXIA Y/U OTRA CIRUGIA ANTIRREFLUJ | $118.180 | $441.730 |
| 18-02-024-01 | — | BANDA GASTRICA POR LAPAROSCOPIA | $314.190 | $441.730 |
| 18-02-024-02 | — | GASTROPEXIA VIA LAPAROSCOPICA | $314.190 | $441.730 |
| 18-02-025-00 | — | VAGOTOMIA SELECTIVA Y SUPERSELECTIVA C/S | $118.180 | $420.180 |
| 18-02-026-00 | — | ABSCESO HEPATICO, TRAT. QUIR. | $118.180 | $392.940 |
| 18-02-027-00 | — | COLANGIOENTEROANASTOMOSIS INTRAHEPATICA | $314.190 | $771.340 |
| 18-02-028-00 | — | COLECISTECTOMIA C/S COLANGIOGRAFIA OPERA | $118.180 | $422.750 |
| 18-02-029-00 | — | COLECISTECTOMIA Y COLEDOCOSTOMIA (SONDA | $118.180 | $474.080 |
| 18-02-030-00 | — | COLECISTOGASTROANASTOMOSIS O COLECISTOEN | $118.180 | $599.230 |
| 18-02-031-00 | — | COLECISTOSTOMIA (PROC. AUT.) | $118.180 | $251.280 |
| 18-02-032-00 | — | COLEDOCO O HEPATOENTEROANASTOMOSIS | $314.190 | $607.300 |
| 18-02-033-00 | — | COLEDOCOSTOMIA SUPRADUODENAL O HEPATICOS | $118.180 | $388.080 |
| 18-02-034-00 | — | COLOCACION DE VALVULA PERITONEOYUGULAR D | $118.180 | $230.860 |
| 18-02-035-00 | — | DESCONEXION ACIGOPORTAL CON TRANSECCION | $530.150 | $763.580 |
| 18-02-036-00 | — | DESCONEXION ACIGOPORTAL SIN TRANSECCION | $530.150 | $607.300 |
| 18-02-037-00 | — | DRENAJE VIA BILIAR TRANSHEPATICO | $118.180 | $392.940 |
| 18-02-038-00 | — | ESFINTEROPLASTIA TRANSDUODENAL, (PROC. A | $314.190 | $506.130 |
| 18-02-039-00 | — | HEPATECTOMIA SEGMENTARIA (PROC. AUT.) | $314.190 | $642.690 |
| 18-02-040-00 | — | HERIDA TRAUMATICA DE HIGADO Y/O VIA BILI | $118.180 | $449.380 |
| 18-02-041-00 | — | LOBECTOMIA HEPATICA (PROC. AUT.) | $530.150 | $859.580 |
| 18-02-042-00 | — | QUISTE HIDATIDICO, UNICO O MULTIPLE, Y/O | $314.190 | $424.270 |
| 18-02-043-00 | — | ABSCESOS, QUISTES, PSEUDOQUISTES O SIMIL | $118.180 | $444.560 |
| 18-02-044-00 | — | HERIDAS, TRAUMATISMOS DE PANCREAS, TRAT. | $118.180 | $334.340 |
| 18-02-045-00 | — | PANCREATECTOMIA PARCIAL | $314.190 | $641.150 |
| 18-02-046-00 | — | PANCREATECTOMIA TOTAL C/S ESPLENECTOMIA | $530.150 | $973.420 |
| 18-02-047-00 | — | PANCREATODUODENECTOMIA | $530.150 | $919.170 |
| 18-02-048-00 | — | SECUESTRECTOMIA EN PANCREATITIS AGUDA | $118.180 | $591.200 |
| 18-02-049-00 | — | AUTOIMPLANTE DE BAZO (INCLUYE ESPLENECTO | $314.190 | $444.560 |
| 18-02-050-00 | — | ESPLENECTOMIA TOTAL O PARCIAL (PROC. AUT | $118.180 | $414.510 |
| 18-02-051-00 | — | OPERACION DE ETAPIFICACION (INCLUYE ESPL | $314.190 | $514.180 |
| 18-02-052-00 | — | SUTURA ESPLENICA (PROC. AUT.) | $118.180 | $334.340 |
| 18-02-053-00 | — | APENDICECTOMIA Y/O DREN. ABSCESO APENDIC | $118.180 | $296.180 |
| 18-02-053-01 | — | APENDICECTOMIA POR LAPAROSCOPIA | $314.190 | $296.180 |
| 18-02-054-00 | — | CIERRE DE COLOSTOMIA (PROC. AUT.) | $118.180 | $258.610 |
| 18-02-055-00 | — | COLOSTOMIA (PROC. AUT.) | $118.180 | $300.510 |
| 18-02-056-00 | — | COLOSTOMIA,COMPLICACIONES TARDIAS,TRAT. | $118.180 | $299.730 |
| 18-02-057-00 | — | DIVERTICULO DE MECKEL, TRAT. QUIR. | $118.180 | $236.690 |
| 18-02-058-00 | — | ENTERO-ENTEROANASTOMOSIS O ENTEROCOLOANA | $118.180 | $359.600 |
| 18-02-059-00 | — | ENTEROTOMIA O ENTEROSTOMIA (YEYUNOSTOMIA | $118.180 | $236.690 |
| 18-02-060-00 | — | ILEOSTOMIA TERMINAL O EN ASA (PROC. AUT. | $118.180 | $300.510 |
| 18-02-061-00 | — | INVAGINACION INTESTINAL, TRAT. QUIR. | $118.180 | $250.450 |
| 18-02-062-00 | — | PERSISTENCIA CONDUCTO ONFALOMESENTERICO, | $118.180 | $230.740 |
| 18-02-063-00 | — | QUISTE URACO, TRAT. QUIR. | $118.180 | $237.870 |
| 18-02-065-00 | — | OCLUSION INTESTINAL CON RESECCION | $118.180 | $414.780 |
| 18-02-066-00 | — | OCLUSION INTESTINAL SIN RESECCION | $118.180 | $353.920 |
| 18-02-067-00 | — | COLECTOMIA PARCIAL O HEMICOLECTOMIA | $314.190 | $659.260 |
| 18-02-067-01 | — | COLOSTOMIA POR LAPAROSCOPIA | $314.190 | $659.260 |
| 18-02-067-02 | — | COLECTOMIA PARCIAL LAPAROSCOPICA | $314.190 | $659.260 |
| 18-02-068-00 | — | COLECTOMIA TOTAL ABDOMINAL | $314.190 | $808.060 |
| 18-02-069-00 | — | DESCENSO DE COLON C/CONSERVACION DEL ESF | $314.190 | $780.940 |
| 18-02-070-00 | — | HARTMANN, OPERACION DE (O SIMILAR) | $314.190 | $641.150 |
| 18-02-071-00 | — | PERFORACION Y/O HERIDA DE INTESTINO, UNI | $118.180 | $317.170 |
| 18-02-072-00 | — | QUISTE Y/O TUMOR DEL MESENTERIO Y/O EPIP | $118.180 | $292.160 |
| 18-02-073-00 | — | RECONSTITUCION TRANSITO POST OPERACION | $314.190 | $642.690 |
| 18-02-074-00 | — | RESECCION DE INTESTINO Y ENTEROANASTOMOS | $118.180 | $473.950 |
| 18-02-075-00 | — | RESECCION INTESTINAL MASIVA POR TROMBOSI | $314.190 | $771.200 |
| 18-02-076-00 | — | DUPLICACION INTESTINAL, TRAT. QUIR. | $118.180 | $381.820 |
| 18-02-077-00 | — | MAL ROTACION INTESTINAL, TRAT. QUIR. | $118.180 | $404.060 |
| 18-02-079-00 | — | GASTRECTOMIA TOTAL CON OSTOMIAS PROXIMAL | $314.190 | $530.480 |
| 18-02-080-00 | — | RECONSTITUCION DE TRANSITO EN 2ø TIEMPO | $314.190 | $416.860 |
| 18-02-081-00 | — | COLECISTECTOMIA POR VIDEOLAPAROSCOPIA, P | $314.190 | $569.420 |
| 18-02-082-00 | — | RESECCION INTESTINAL CON OSTOMIAS PROXIM | $118.180 | $392.240 |
| 18-02-100-00 | — | TRASPLANTE HEPATICO | $530.150 | $1.503.920 |
| 18-02-124-00 | — | BANDING GASTRICO | $2 | No disponible |
| 18-02-141-00 | — | RETIRO GASTROTOMIA | $50.000 | $50.000 |
| 18-02-148-00 | — | YEYUNOPANCREATOSTOMIA | $314.190 | $686.540 |
| 18-02-154-00 | — | HERNIA ABDOMINAL POR ACCESO MINIINVASIVO | $118.180 | $620.370 |
| 18-02-155-00 | — | HERNIA DIAFRAG ,HIATAL,VENTRAL(RETROMUSC | $118.180 | $689.280 |
| 18-02-158-00 | — | CIRUGIA BARIATRICA BY PASS GASTRICO LAPA | $1.649.130 | No disponible |
| 18-02-159-00 | — | CIRUGIA BARIATRICA MANGA GASTRICA POR LA | $1.425.100 | No disponible |
| 18-02-802-00 | — | HERNIA INGUINAL CON MALLA (ADULTOS) | $2 | No disponible |
| 18-03-001-00 | — | ABSCESO ANORRECTAL COMPLEJO (IMPLICA HOS | $118.180 | $250.670 |
| 18-03-002-00 | — | ABSCESO ANORRECTAL SIMPLE , TRAT. QUIR. | $151.640 | $97.440 |
| 18-03-003-00 | — | ABSCESO SACROCOXIGEO, DRENAJE | $84.240 | $54.130 |
| 18-03-004-00 | — | BIOPSIA QUIRURGICA RECTAL (PROC. AUT.) | $118.180 | $54.130 |
| 18-03-004-01 | — | BIOPSIA CORE TRANSRECTAL O PROSTATICA | $80.000 | $80.000 |
| 18-03-006-00 | — | CUERPO EXTRANO RECTAL, EXTRACCION POR VI | $118.180 | $304.980 |
| 18-03-007-00 | — | CUERPO EXTRANO RECTAL, EXTRACCION POR VI | $143.320 | $92.100 |
| 18-03-008-00 | — | DESGARROS Y HERIDAS ANORRECTALES CON COM | $118.180 | $260.670 |
| 18-03-009-00 | — | DESGARROS Y HERIDAS ANORRECTALES SIN COM | $118.180 | $227.570 |
| 18-03-010-00 | — | ESFINTEROTOMIA (PROC. AUT.) | $118.180 | $108.830 |
| 18-03-011-00 | — | ESTENOSIS ANAL, PLASTIA | $118.180 | $230.670 |
| 18-03-012-00 | — | ESTENOSIS RECTAL, PLASTIA | $118.180 | $230.670 |
| 18-03-013-00 | — | FECALOMA, TRAT. QUIR. | $118.180 | $347.010 |
| 18-03-014-00 | — | FISTULA RECTOVESICAL, TRAT.QUIR. | $118.180 | $381.820 |
| 18-03-015-00 | — | FISTULA RECTOVAGINAL, RECTOURETRAL O URE | $118.180 | $304.980 |
| 18-03-016-00 | — | FISTULA ANORRECTAL, TRAT.QUIR.DE CUALQUI | $118.180 | $237.620 |
| 18-03-017-00 | — | FISURA ANAL, REPAR. QUIR. | $118.180 | $128.110 |
| 18-03-018-00 | — | HEMORROIDECTOMIA (INCLUYE OTRAS OPERACIO | $118.180 | $286.540 |
| 18-03-019-00 | — | HEMORROIDES, TROMBECTOMIA (PROC. AUT.) | $59.980 | $38.540 |
| 18-03-020-00 | — | IMPERFORACION ANAL,RECONSTITUCION TRANSI | $314.190 | $381.820 |
| 18-03-021-00 | — | IMPERFORACION ANAL, RECONSTITUCION TRANS | $118.180 | $230.740 |
| 18-03-023-00 | — | INCONTINENCIA ANAL, TRAT.QUIR. CON CERCL | $118.180 | $230.860 |
| 18-03-024-00 | — | INCONTINENCIA ANAL, TRAT.QUIR. CON PLAST | $118.180 | $297.090 |
| 18-03-025-00 | — | POLIPO RECTAL, TRAT.QUIR. POR VIA ABDOMI | $118.180 | $304.980 |
| 18-03-026-00 | — | POLIPO RECTAL, TRAT.QUIR. POR VIA ANAL | $118.180 | $230.860 |
| 18-03-027-00 | — | PROLAPSO RECTAL, TRAT.QUIR. POR VIA ABDO | $118.180 | $389.620 |
| 18-03-028-00 | — | PROLAPSO RECTAL, TRAT.QUIR. POR VIA ANAL | $118.180 | $250.450 |
| 18-03-029-00 | — | PANPROCTOCOLECTOMIA (2 EQUIPOS) | $530.150 | $896.850 |
| 18-03-030-00 | — | PRURITO ANAL, TRAT. QUIR. POR DENERVACIO | $118.180 | $115.390 |
| 18-03-031-00 | — | QUISTE SACROCOXIGEO, TRAT. QUIR. | $118.180 | $237.440 |
| 18-03-032-00 | — | RESECCION ABDOMINO-PERINEAL DE ANO Y REC | $314.190 | $607.300 |
| 18-03-033-00 | — | RESECCION ABDOMINO-PERINEAL DE ANO Y REC | $530.150 | $686.540 |
| 18-03-034-00 | — | RESECCION ANTERIOR DE RECTO | $314.190 | $543.170 |
| 18-03-035-00 | — | RESECCION PERINEAL DE ANO Y RECTO | $314.190 | $379.820 |
| 18-03-036-00 | — | A LOS CIRUJANOS DEL EQUIPO PERINEAL EN C | $633.180 | $406.860 |
| 18-03-038-00 | — | CONDILOMAS ANALES, TRAT. QUIR.(PARA ELEC | $118.180 | $187.780 |
| 18-50-011-00 | — | BALON GASTRICO | $26.270 | No disponible |
| 18-50-012-00 | — | RETIRO BALON GASTRICO | $26.270 | No disponible |
| 19-01-001-00 | — | EXPLORACION DE URETRA ANTERO-POSTERIOR C | $15.460 | $9.940 |
| 19-01-002-00 | — | CISTOSCOPIA CON SONDEO DE UNO O AMBOS UR | $118.180 | $69.840 |
| 19-01-003-00 | — | CISTOSCOPIA Y/O URETROCISTOSCOPIA Y/O UR | $99.130 | $63.700 |
| 19-01-004-00 | — | URETERONEFROSCOPIA | $118.180 | $108.640 |
| 19-01-005-00 | — | BIOPSIA TRANSRECTAL DE PROSTATA | $108.690 | $69.840 |
| 19-01-006-00 | — | RENAL TRANSPARIETAL | $39.520 | $25.390 |
| 19-01-007-00 | — | CISTOMETRIA (PROC.AUT.) | $50.750 | $32.610 |
| 19-01-011-00 | — | UROFLUJOMETRIA (PROC.AUT.) | $33.120 | $21.280 |
| 19-01-012-00 | — | CISTOGRAFIA POR SONDA (DE RELLENO) O POR | $34.710 | $22.300 |
| 19-01-013-00 | — | INYECCION DE MEDIO DE CONTRASTE EN CUERP | $32.000 | $20.560 |
| 19-01-015-00 | — | URETEROPIELOGRAFIA ASCENDENTE (DIRECTA) | $124.580 | $80.050 |
| 19-01-016-00 | — | URETROGRAFIA RETROGRADA O CISTOURETROGRA | $22.880 | $14.700 |
| 19-01-018-00 | — | DILATACION URETRA C/S MASAJE, C/S INSTIL | $26.640 | $17.120 |
| 19-01-019-00 | — | INSTILACION VESICAL (INCLUYE COLOCACION | $21.740 | $13.970 |
| 19-01-020-00 | — | INYECCION DE MEDICAMENTOS EN EL PENE | $22.880 | $14.700 |
| 19-01-022-00 | — | VAC. VESICAL POR SONDA URETRAL, (PROC. A | $25.170 | $16.180 |
| 19-01-025-00 | — | PERITONEODIALISIS POR SESION | $350.000 | $350.000 |
| 19-01-030-00 | — | ESTUDIO URODINAMICO (INCLUYE CISTOMETRIA | $175.820 | $112.980 |
| 19-01-100-00 | — | NEFROSTOMIA PERCUTANEA | $900.000 | $900.000 |
| 19-01-102-00 | — | RETIRO CATETER PIG TAIL | $118.180 | $69.840 |
| 19-01-123-00 | — | HEMODIALISIS EN UNIDAD PACIENTE CRITICO | $434.050 | $434.050 |
| 19-01-124-00 | — | DIALISIS CONTINUA X HORA | $109.070 | $109.070 |
| 19-01-125-00 | — | HORA ADICIONAL HEMODIALISIS EN UPC | $99.000 | $99.000 |
| 19-02-002-00 | — | ARTERIAS RENALES, OPERACIONES SOBRE (PRO | $314.190 | $745.810 |
| 19-02-003-00 | — | AUTO O HETEROTRANSPLANTE | $530.150 | $1.131.060 |
| 19-02-004-00 | — | CIRUGIA DE BANCO, (PROC. COMPLETO)(MICRO | $530.150 | $1.084.430 |
| 19-02-005-00 | — | LITIASIS RENAL, TRAT. QUIR. PERCUTANEO C | $118.180 | $661.330 |
| 19-02-006-00 | — | LITIASIS RENAL, TRAT. QUIR. POR NEFROTOM | $118.180 | $510.180 |
| 19-02-008-00 | — | LUMBOTOMIA EXPLORADORA C/S DREN., C/S BI | $118.180 | $344.780 |
| 19-02-009-00 | — | NEFRECTOMIA PARCIAL Y/O CIRUGIA DE TRAUM | $314.190 | $794.030 |
| 19-02-009-01 | — | NEFRECTOMIA PARCIAL LAPAROSCOPICA | $314.190 | $794.030 |
| 19-02-010-00 | — | NEFRECTOMIA RADICAL AMPLIADA (INCLUYE GA | $314.190 | $771.550 |
| 19-02-010-01 | — | NEFRECTOMIA RADICAL LAPAROSCOPICA | $314.190 | No disponible |
| 19-02-011-00 | — | NEFRECTOMIA POR PATOLOGIA BENIGNA O MALF | $118.180 | $404.060 |
| 19-02-012-00 | — | DRENAJE PERCUTANEO O ENDOSCOPICO DE HIDR | $118.180 | $372.850 |
| 19-02-013-00 | — | PIELOTOMIA EXPLORADORA Y/O TERAPEUTICA ( | $118.180 | $550.960 |
| 19-02-015-00 | — | SUPRARRENALECTOMIA UNILATERAL | $118.180 | $525.460 |
| 19-02-016-00 | — | ANASTOMOSIS DE LOS URETERES | $314.190 | $544.100 |
| 19-02-017-00 | — | FISTULA URETERO-VAGINAL, TRAT. QUIR. | $118.180 | $461.260 |
| 19-02-018-00 | — | NEFROURETERECTOMIA EN PATOLOGIA TUMORAL | $314.190 | $709.920 |
| 19-02-019-00 | — | URETERECTOMIA | $118.180 | $474.350 |
| 19-02-020-00 | — | URETERO-LITOTOMIA ABIERTA | $118.180 | $369.070 |
| 19-02-021-00 | — | URETERO-LITOTOMIA ENDOSCOPICA C/URETEROS | $118.180 | $631.500 |
| 19-02-022-00 | — | URETEROPLASTIAS, PROC. COMPLETO | $314.190 | $572.960 |
| 19-02-023-00 | — | URETERORRAFIA Y/O URETEROLISIS C/U | $118.180 | $414.510 |
| 19-02-024-00 | — | URETEROSTOMIA BILATERAL:VESICAL,CUTANEA | $314.190 | $764.670 |
| 19-02-025-00 | — | URETEROSTOMIA UNILATERAL: VESICAL, CUTAN | $118.180 | $581.650 |
| 19-02-027-00 | — | CISTECTOMIA PARCIAL Y/O TRAT. QUIR. DE D | $118.180 | $356.210 |
| 19-02-028-00 | — | CISTECTOMIA RADICAL, PROC COMPLETO. | $314.190 | $1.090.800 |
| 19-02-029-00 | — | CISTOPLASTIA, PROC. COMPLETO | $314.190 | $722.560 |
| 19-02-030-00 | — | CISTORRAFIA, PROC. COMPLETO | $118.180 | $230.740 |
| 19-02-031-00 | — | CISTOSTOMIA C/S EXTRACCION DE CUERPO EXT | $118.180 | $230.740 |
| 19-02-032-00 | — | EXTROFIA VESICAL, PROC. COMPLETO | $118.180 | $502.220 |
| 19-02-033-00 | — | FISTULA VESICO-CUTANEA, Y/O VAGINAL, Y/O | $118.180 | $369.070 |
| 19-02-034-00 | — | LESIONES DEL CUELLO VESICAL, TRAT. QUIR. | $118.180 | $276.830 |
| 19-02-035-00 | — | LIGADURA DE ARTERIAS HIPOGASTRICAS (PROC | $118.180 | $292.910 |
| 19-02-036-00 | — | OPERACION DE BRICKER | $314.190 | $826.080 |
| 19-02-037-00 | — | RESECCION ENDOSCOPICA DE CANCER VESICAL | $314.190 | $333.150 |
| 19-02-038-00 | — | RESERVORIO CONTINENTE INTESTINAL EXTERNO | $314.190 | $722.560 |
| 19-02-040-00 | — | DIVERTICULECTOMIA POR VIA VAGINAL,PERINE | $118.180 | $381.820 |
| 19-02-041-00 | — | FLEGMON URINOSO, DRENAJE Y CISTOSTOMIA | $118.180 | $263.980 |
| 19-02-043-00 | — | HIPOSPADIA DISTAL O PLASTIA DE URETRA (C | $118.180 | $299.730 |
| 19-02-044-00 | — | HIPOSPADIA PROXIMAL, TRAT. QUIR. EN UN T | $118.180 | $389.620 |
| 19-02-045-00 | — | INCONTINENCIA URINARIA, TRAT. QUIR. POR | $118.180 | $366.400 |
| 19-02-047-00 | — | MEATOTOMIA QUIRURGICA C/S RESECCION DE P | $118.180 | $184.910 |
| 19-02-049-00 | — | URETRECTOMIA C/S CISTOSTOMIA | $118.180 | $859.420 |
| 19-02-050-00 | — | PLASTIA DE URETRA O TRAT. DE FISTULAS RE | $118.180 | $230.740 |
| 19-02-051-00 | — | URETROSTOMIA | $118.180 | $184.660 |
| 19-02-052-00 | — | URETROTOMIA EXTERNA (PROC. AUT.) | $118.180 | $230.740 |
| 19-02-053-00 | — | URETROTOMIA INTERNA Y/O URETROLITOTOMIA | $118.180 | $263.980 |
| 19-02-054-00 | — | ABSCESO, TRAT. QUIR. | $118.180 | $236.850 |
| 19-02-055-00 | — | ADENOMA O CANCER PROSTATICO, RESECCION E | $118.180 | $371.540 |
| 19-02-055-01 | — | HEMOSTASIA POR HEMOVEJIGA | $578.200 | $371.540 |
| 19-02-056-00 | — | ADENOMA PROSTATICO, TRAT. QUIR. CUALQUIE | $118.180 | $435.740 |
| 19-02-057-00 | — | TUMORES MALIGNOS DE PROSTATA O VESICULAS | $314.190 | $771.550 |
| 19-02-059-00 | — | BIOPSIA QUIRURGICA (UNO O AMBOS) (PROC. | $118.180 | $243.760 |
| 19-02-060-00 | — | DESCENSO TESTICULO ABDOMINAL C/S HERNIOP | $118.180 | $324.350 |
| 19-02-061-00 | — | DESCENSO TESTICULO INGUINAL C/S HERNIOPL | $118.180 | $300.510 |
| 19-02-062-00 | — | ESCROTO, PLASTIA DE, PROC. COMPLETO | $118.180 | $236.850 |
| 19-02-063-00 | — | HIDATIDECTOMIA UNILAT.C/S EVERSION DE LA | $118.180 | $236.850 |
| 19-02-064-00 | — | HIDROCELE Y/O HEMATOCELE, TRAT. QUIR. | $118.180 | $230.860 |
| 19-02-065-00 | — | ORQUIDECTOMIA UN LADO | $118.180 | $230.860 |
| 19-02-066-00 | — | ORQUIDOPEXIA UN LADO | $118.180 | $250.670 |
| 19-02-067-00 | — | PROTESIS TESTICULAR, (PROC. AUT.) | $118.180 | $244.380 |
| 19-02-068-00 | — | TUMORES MALIGNOS DEL TESTICULO, ORQUIDEC | $118.180 | $276.830 |
| 19-02-069-00 | — | TUMORES MALIGNOS DEL TESTICULO, ORQUIDEC | $314.190 | $666.560 |
| 19-02-070-00 | — | ANASTOMOSIS DE LOS DEFERENTES | $118.180 | $354.080 |
| 19-02-071-00 | — | EPIDIDIMECTOMIA PARCIAL O TOTAL, UN LADO | $118.180 | $251.280 |
| 19-02-072-00 | — | PLASTIA EPIDIDIMO-DEFERENTE (OPERACION D | $118.180 | $343.490 |
| 19-02-073-00 | — | QUISTES DEL CORDON, Y/O EPIDIDIMO, EXTIR | $118.180 | $230.860 |
| 19-02-074-00 | — | TORSION DEL CORDON, TRAT. QUIR. (INCLUYE | $118.180 | $243.570 |
| 19-02-075-00 | — | VARICOCELE UNILATERAL, TRAT. QUIR. | $118.180 | $230.860 |
| 19-02-075-01 | — | VARICOCELE POR LAPAROSCOPIA | $118.180 | $230.860 |
| 19-02-076-00 | — | VASECTOMIA BILATERAL, (PROC. AUT.) (LA V | $118.180 | $250.670 |
| 19-02-078-00 | — | AMPUTACION PARCIAL DEL PENE (PROC.AUT.) | $118.180 | $276.830 |
| 19-02-079-00 | — | AMPUTACION TOTAL DEL PENE, PROC. COMPLET | $118.180 | $422.750 |
| 19-02-080-00 | — | BIOPSIA DE PENE (PROC. AUT.) | $89.910 | $57.780 |
| 19-02-081-00 | — | CAVERNOSOSTOMIA Y/O CAVERNO-ESPONGIOSTOM | $118.180 | $268.770 |
| 19-02-082-00 | — | CIRCUNCISION (INCLUYE SECCION DE FRENILL | $118.180 | $250.450 |
| 19-02-083-00 | — | LESIONES DEL CUERPO CAVERNOSO, TRAT. QUI | $118.180 | $257.780 |
| 19-02-084-00 | — | MEATOTOMIA HOMBRE Y/O SECCION FRENILLO Y | $26.270 | $35.520 |
| 19-02-085-00 | — | PLASTIA DE PENE, PROC. COMPLETO (NO INCL | $118.180 | $486.320 |
| 19-02-090-00 | — | LITIASIS RENAL TRAT. POR ONDA DE CHOQUE | $314.190 | $647.810 |
| 19-02-112-00 | — | INSTALACION CATETER DOBLE J ANTEROGRADO | $118.180 | No disponible |
| 19-02-131-00 | — | LITOTRIPSIA ENDOSCOPICA TEC LASER | $118.180 | $86.110 |
| 20-01-002-00 | — | COLPOSCOPIA | $23.780 | $15.280 |
| 20-01-005-00 | — | HISTEROSCOPIA DIAGNOSTICA O TERAPEUTICA | $26.270 | $36.800 |
| 20-01-006-00 | — | AMNIOCENTESIS | $35.480 | $22.800 |
| 20-01-007-00 | — | CULDOCENTESIS (PUNCION DEL DOUGLAS) | $43.430 | $27.900 |
| 20-01-009-00 | — | MONITOREO BASAL CON INFORME | $15.610 | $10.030 |
| 20-01-010-00 | — | MONITOREO FETAL ESTRESANTE, CON CONTROL | $44.570 | $28.640 |
| 20-01-012-00 | — | GALACTOGRAFIA Y NEUMOCISTOGRAFIA (A.C.04 | $37.520 | $24.110 |
| 20-01-013-00 | — | HISTEROSALPINGOGRAFIA (A.C. 04-02-011) | $45.770 | $29.410 |
| 20-01-013-01 | — | HISTEROSONOGRAFIA | $45.770 | $29.410 |
| 20-01-014-00 | — | BIOPSIA ENDOMETRIO, VULVA, VAGINA, CUELL | $44.600 | $28.660 |
| 20-01-015-00 | — | COLOCACION O EXTRACCION DE DISPOSITIVO | $28.060 | $18.030 |
| 20-01-015-01 | — | INSERCION NORPLANT | $30.000 | $30.000 |
| 20-01-015-02 | — | INSERCION / EXTRACCION NORPLANT | $50.000 | $50.000 |
| 20-01-016-01 | — | CRIOTERAPIA | $45.770 | $29.410 |
| 20-01-020-00 | — | TEST POSTCOITAL | $45.770 | $29.410 |
| 20-01-021-00 | — | CORDOCENTESIS | $78.610 | $50.510 |
| 20-01-022-00 | — | PUNCION EVACUADORA DE QUISTES MAMARIOS, | $31.520 | $20.260 |
| 20-01-022-01 | — | PUNCION QUISTE MAMARIO BAJO ECO | $31.520 | $20.260 |
| 20-01-120-00 | — | PUNCION MAMARIA | $60.000 | $60.000 |
| 20-01-122-00 | — | BIOPSIA CORE MAMARIA 1 | $120.000 | $120.000 |
| 20-01-123-00 | — | BIOPSIA CORE MAMARIA 2 | $180.000 | $180.000 |
| 20-01-124-00 | — | BIOPSIA CORE MAMARIA 3 | $240.000 | $240.000 |
| 20-02-001-00 | — | ABSCESO Y/O HEMATOMA DE MAMA, TRAT.QUIR. | $26.270 | $64.220 |
| 20-02-002-00 | — | MASTECTOMIA PARCIAL (CUADRANTECTOMIA O S | $118.180 | $338.850 |
| 20-02-003-00 | — | MASTECTOMIA RADICAL O TUMORECTOMIA C/VAC | $118.180 | $607.300 |
| 20-02-005-00 | — | TUMOR BENIGNO Y/O QUISTE Y/O MAMA SUPERN | $118.180 | $230.860 |
| 20-03-001-00 | — | OOFORECTOMIA PARCIAL O TOTAL, UNI O BILA | $118.180 | $237.620 |
| 20-03-001-01 | — | OOFORECTOMIA POR LAPAROSCOPIA | $314.190 | $237.620 |
| 20-03-002-00 | — | ANEXECTOMIA Y/O VAC. DE ABSCESO TUBO-OVA | $118.180 | $292.160 |
| 20-03-002-01 | — | ANEXECTOMIA POR LAPAROSCOPIA | $314.190 | $292.160 |
| 20-03-003-00 | — | EMBARAZO TUBARIO, TRAT. QUIR. | $118.180 | $342.180 |
| 20-03-003-01 | — | EMBARAZO TUBARIO POR LAPAROSCOPIA | $314.190 | $342.180 |
| 20-03-004-00 | — | LIGADURA O SECCION UNI O BILATERAL DE LA | $118.180 | $230.860 |
| 20-03-004-01 | — | POMEROY POR LAPAROSCOPIA | $314.190 | $230.860 |
| 20-03-005-00 | — | SALPINGECTOMIA UNI O BILATERAL | $118.180 | $250.670 |
| 20-03-005-01 | — | SALPINGECTOMIA POR LAPAROSCOPIA | $314.190 | $250.670 |
| 20-03-006-00 | — | ESTERILIDAD TUBARIA, OPERACION PLAST C/M | $314.190 | $502.220 |
| 20-03-006-01 | — | ESTERILIDAD TUBARIA LAPAROSCOPICA | $314.190 | $502.220 |
| 20-03-007-00 | — | ESTERILIDAD TUBARIA, OPERACION PLAST S/M | $118.180 | $330.540 |
| 20-03-007-01 | — | ESTERILIDAD TUBARIA POR LAPAROSCOPIA | $314.190 | $330.540 |
| 20-03-008-00 | — | MIOMECTOMIA | $118.180 | $278.580 |
| 20-03-008-01 | — | MIOMECTOMIA LAPAROSCOPICA | $314.190 | $278.580 |
| 20-03-009-00 | — | HISTERECTOMIA SUBTOTAL POR VIA ABDOMINAL | $118.180 | $334.340 |
| 20-03-010-00 | — | HISTERECTOMIA TOTAL O AMPLIADA POR VIA A | $118.180 | $758.020 |
| 20-03-010-01 | — | HISTERECTOMIA LAPAROSCOPICA | $314.190 | $758.020 |
| 20-03-011-00 | — | LIGAMENTO ANCHO: ABSCESOS Y/O HEMATOMAS | $118.180 | $336.210 |
| 20-03-011-01 | — | LIGAMENTO ANCHO POR LAPAROSCOPIA | $314.190 | $336.210 |
| 20-03-012-00 | — | CONIZACION Y/O AMPUTACION DEL CUELLO, DI | $118.180 | $230.860 |
| 20-03-013-00 | — | EXANTERACION PELVIANA ANTERIOR Y/O POSTE | $530.150 | $1.129.890 |
| 20-03-014-00 | — | HISTERECTOMIA POR VIA VAGINAL | $118.180 | $599.940 |
| 20-03-015-00 | — | HISTERECTOMIA RADICAL CON DISECCION PELV | $314.190 | $953.220 |
| 20-03-016-00 | — | HISTERECTOMIA TOTAL C/INTERVENCION INCON | $118.180 | $799.440 |
| 20-03-017-00 | — | HISTEROPEXIA | $118.180 | $230.740 |
| 20-03-018-00 | — | PLASTIA UTERINA (OPERACION DE STRASSMAR | $118.180 | $304.980 |
| 20-03-019-00 | — | POLIPECTOMIA (UNO O MAS) (PROC. AUT.) | $26.270 | $70.580 |
| 20-03-020-00 | — | SINEQUIA Y/O ESTENOSIS CERVICAL , TRAT. | $118.180 | $131.440 |
| 20-03-021-00 | — | COLPOCELIOTOMIA | $118.180 | $124.830 |
| 20-03-022-00 | — | INCONTINENCIA URINARIA DE ESFUERZO, TRAT | $118.180 | $292.220 |
| 20-03-023-00 | — | PROLAPSO ANTERIOR Y/O POSTERIOR CON REPA | $118.180 | $422.750 |
| 20-03-024-00 | — | PROLAPSO ANTERIOR Y/O POSTERIOR C/S TRAT | $118.180 | $276.830 |
| 20-03-025-00 | — | QUISTE Y/O DESGARRO Y/O TABIQUE VAGINAL, | $118.180 | $128.110 |
| 20-03-026-00 | — | BARTOLINITIS, VACIAMIENTO Y DRENAJE (PRO | $84.240 | $54.130 |
| 20-03-027-00 | — | BARTOLINOCISTONEOSTOMIA O EXTIRP. DE LA | $118.180 | $243.760 |
| 20-03-028-00 | — | VULVECTOMIA RADICAL | $118.180 | $722.560 |
| 20-03-029-00 | — | VULVECTOMIA SIMPLE | $118.180 | $397.300 |
| 20-03-030-00 | — | DESGARRO CERVICAL TRAT. QUIR. | $118.180 | $230.860 |
| 20-03-031-00 | — | VIDEOLAPAROSCOPIA GINECOLOGICA EXPLORADO | $118.180 | $199.180 |
| 20-03-040-00 | — | INCOMPETENCIA CERVICAL TRAT. QUIR. | $118.180 | $260.820 |
| 20-03-041-00 | — | EXTRACCION DE DIU INCRUSTADO, POR VIA AB | $118.180 | $279.250 |
| 20-03-100-00 | — | HIPERTROFIA NINFAS | $118.180 | $30.370 |
| 20-04-001-00 | — | ABORTO RETENIDO, VACIAMIENTO DE (INCLU | $26.270 | $194.660 |
| 20-04-002-00 | — | RASPADO UTERINO DIAGNOSTICO O TERAPEUT | $26.270 | $173.550 |
| 20-04-003-00 | — | PARTO PRESENTACION CEFALICA O PODALICA, | $118.180 | $284.690 |
| 20-04-003-01 | — | PARTO PABELLON CENTRAL | $118.180 | $284.690 |
| 20-04-003-02 | — | PARTO (SAIP) | $118.180 | No disponible |
| 20-04-005-00 | — | CESAREA CON HISTERECTOMIA | $118.180 | $421.540 |
| 20-04-006-00 | — | CESAREA C/S SALPINGOLIGADURA O SALPINGEC | $118.180 | $377.680 |
| 20-04-006-01 | — | CESAREA PABELLON CENTRAL | $118.180 | $377.680 |
| 20-04-007-00 | — | ASPIRACION MANUAL ENDOUTERINA (AMEU) | $26.270 | $95.680 |
| 20-04-009-00 | — | FOTOTERAPIA RECIEN NACIDO (POR DIA) | $3.460 | $2.220 |
| 20-04-010-00 | — | HONORARIO MATRONA PREPARTO | $58.890 | No disponible |
| 20-04-011-00 | — | HONORARIO MATRONA ATENCION INTEGRAL | $155.870 | No disponible |
| 20-04-012-00 | — | HONORARIO MATRONA POST PARTO | $93.520 | No disponible |
| 20-04-100-00 | — | INSEMINACION BAJA COMPLEJIDAD | $80.000 | $80.000 |
| 20-05-001-00 | — | SESION REHABILITACION PISO PELVICO | $25.000 | $25.000 |
| 20-05-101-00 | — | EVALUACION PISO PELVICO | $5.000 | $5.000 |
| 21-01-001-00 | — | INFILTRACION LOCAL MEDICAMENTOS (BURSAS, | $19.470 | $12.510 |
| 21-01-001-01 | — | INFILTRACION LOCAL /PUNCION EVACUADORA B | $19.120 | $12.290 |
| 21-01-002-00 | — | PROCEDIM. PARA EXPLORACIONES RADIOLOGICA | $21.140 | $13.580 |
| 21-01-003-00 | — | MOVILIZACION ARTICULAR BAJO ANESTESIA GE | $118.180 | $69.100 |
| 21-01-100-00 | — | ARTROCENTESIS EN SERV DE URGENCIA | $19.470 | No disponible |
| 21-04-001-00 | — | ARTROSCOPIA DIAGNOSTICA C/S BIOPSIA, C/S | $26.270 | $313.010 |
| 21-04-002-00 | — | EXOSTOSIS U OSTEOCONDROMA, TRAT. QUIR. | $26.270 | $243.760 |
| 21-04-003-00 | — | QUISTES SINOVIALES DE VAINAS FLEXORAS, B | $358.060 | $230.080 |
| 21-04-003-01 | — | QUISTE SINOVIAL 1 CIRUJANO | $358.060 | $230.080 |
| 21-04-004-00 | — | TRACCION HALOCRANEANA O ESTRIBO-CRANEANA | $26.270 | $57.780 |
| 21-04-005-00 | — | TRACCION HALOCRANEO-FEMORAL | $26.270 | $230.670 |
| 21-04-006-00 | — | TRACCION TRANSESQUELETICA O DE PARTES BL | $26.270 | $34.510 |
| 21-04-007-00 | — | ARTRODESIS DE CODO O MUNECA, C/U | $26.270 | $224.940 |
| 21-04-008-00 | — | ARTRODESIS DE HOMBRO, CADERA,RODILLA, TO | $118.180 | $343.090 |
| 21-04-009-00 | — | ARTRODESIS DE MANO O PIE C/U | $26.270 | $250.670 |
| 21-04-010-00 | — | TRATAMIENTO COMPLETO DE FRACTURAS EXPUES | $118.180 | $358.830 |
| 21-04-011-00 | — | TRATAMIENTO COMPLETO DE FRACTURAS EXPUES | $118.180 | $266.400 |
| 21-04-012-00 | — | OSTEITIS, RASPADO, C/S SECUESTRECTOMIA | $118.180 | $216.220 |
| 21-04-013-00 | — | OSTEOMIELITIS AGUDA HEMATOGENA, DRENAJE | $118.180 | $266.400 |
| 21-04-014-00 | — | OSTEOMIELITIS CRONICA HUESOS LARGOS, LEG | $118.180 | $240.960 |
| 21-04-015-00 | — | ARTROTOMIA HOMBRO O CADERA C/U | $118.180 | $240.210 |
| 21-04-016-00 | — | ARTROTOMIA OTRAS ARTICULACIONES, C/U | $118.180 | $250.670 |
| 21-04-017-00 | — | PSEUDOARTROSIS INFECTADA HUESOS LARGOS, | $118.180 | $343.090 |
| 21-04-018-00 | — | AUTOTRANSPLANTE OSEO MICROQUIRURGICO | $314.190 | $735.380 |
| 21-04-019-00 | — | INJERTO ESPONJOSO METAFISIARIO | $26.270 | $230.860 |
| 21-04-020-00 | — | INJERTOS ESPONJOSOS O CORTICO-ESPONJOSOS | $26.270 | $243.760 |
| 21-04-021-00 | — | TRANSPLANTE OSEO (AUTO U HOMOTRANSPLANT | $118.180 | $512.500 |
| 21-04-022-00 | — | LESIONES QUISTICAS CON FRACTURA PATOLOGI | $118.180 | $353.090 |
| 21-04-023-00 | — | LESIONES QUISTICAS: LEGRADO OSEO, C/S RE | $118.180 | $243.760 |
| 21-04-024-00 | — | METASTASIS OSEA C/S FRACTURA PATOLOGICA, | $118.180 | $343.090 |
| 21-04-025-00 | — | TUMOR OSEO, RESECCION EN BLOQUE, C/S OST | $118.180 | $363.070 |
| 21-04-026-00 | — | TUMORES O QUISTES O LESIONES PSEUDOQUIST | $118.180 | $244.140 |
| 21-04-026-01 | — | PUNCION PARTES BLANDAS | $379.950 | $244.140 |
| 21-04-027-00 | — | TUMORES OSEOS: RESECCION EN BLOQUE,EPIFI | $118.180 | $366.590 |
| 21-04-028-00 | — | TUMORES PRIMARIOS O METASTASICOS VERTEBR | $314.190 | $912.350 |
| 21-04-029-00 | — | SINOVECTOMIAS QUIRURGICAS DE CODO O MUNE | $118.180 | $235.600 |
| 21-04-030-00 | — | SINOVECTOMIAS QUIRURGICAS DE RODILLA O C | $118.180 | $250.670 |
| 21-04-031-00 | — | EPINEURORRAFIA MICROQUIRURGICA CON MAGNI | $314.190 | $309.520 |
| 21-04-033-00 | — | BIOPSIA OSEA POR PUNCION | $77.960 | $50.100 |
| 21-04-034-00 | — | BIOPSIA OSEA QUIRURGICA | $118.180 | $242.290 |
| 21-04-035-00 | — | BIOPSIA SINOVIAL O MUSCULAR POR PUNCION | $26.270 | $50.100 |
| 21-04-036-00 | — | BIOPSIA SINOVIAL O MUSCULAR QUIRURGICA | $97.630 | $62.740 |
| 21-04-037-00 | — | BIOPSIA VERTEBRAL POR PUNCION | $26.270 | $100.130 |
| 21-04-038-00 | — | MUNON DE AMPUTACION, REGULARIZACION DE | $26.270 | $199.180 |
| 21-04-039-00 | — | OSTEOCONDROSIS O EPIFISITIS, TRAT. QUIR. | $118.180 | $199.180 |
| 21-04-040-00 | — | AMPUTACION INTERESCAPULO-TORACICA | $314.190 | $511.900 |
| 21-04-041-00 | — | DESARTICULACION ESCAPULO-HUMERAL | $314.190 | $334.460 |
| 21-04-042-00 | — | ENDOPROTESIS TOTAL DE HOMBRO,(CUALQUIER | $314.190 | $358.830 |
| 21-04-044-00 | — | FRACTURA CUELLO HUMERAL, TRAT. QUIR. | $118.180 | $353.090 |
| 21-04-045-00 | — | FRACTURA DE CLAVICULA, OSTEOSINTESIS | $118.180 | $236.640 |
| 21-04-046-00 | — | FRACTURA ESCAPULA, OSTEOSINTESIS | $118.180 | $238.030 |
| 21-04-047-00 | — | LUXACION ACROMIO-CLAVICULAR O ESTERNO CL | $118.180 | $236.850 |
| 21-04-048-00 | — | LUXACION RECIDIVANTE, TRAT. QUIR. | $118.180 | $363.070 |
| 21-04-049-00 | — | LUXACION TRAUMATICA, REDUCCION CRUENTA | $118.180 | $244.380 |
| 21-04-050-00 | — | LUXOFRACTURA,REDUCCION Y OSTEOSINTESIS | $118.180 | $363.070 |
| 21-04-051-00 | — | RUPTURA MANGUITO ROTADORES, TRAT. QUIR. | $118.180 | $363.070 |
| 21-04-052-00 | — | TRANSPOSICIONES MUSCULARES | $118.180 | $250.670 |
| 21-04-053-00 | — | AMPUTACION BRAZO | $118.180 | $244.140 |
| 21-04-054-00 | — | FRACTURA SUPRACONDILEA NINO TRACCION ES | $118.180 | $243.570 |
| 21-04-055-00 | — | OSTEOSINTESIS DIAFISIARIA (CUALQUIER TEC | $118.180 | $250.670 |
| 21-04-056-00 | — | OSTEOSINTESIS SUPRA O INTERCONDILEA (CUA | $118.180 | $250.450 |
| 21-04-057-00 | — | OSTEOTOMIA (CUALQUIER TECNICA) | $118.180 | $244.380 |
| 21-04-058-00 | — | PSEUDOARTROSIS C/S OSTEOSINTESIS C/S YES | $118.180 | $244.380 |
| 21-04-059-00 | — | ARTROPLASTIA CON FASCIA | $118.180 | $252.060 |
| 21-04-060-00 | — | CUPULA RADIAL, RESECCION | $118.180 | $199.180 |
| 21-04-061-00 | — | CUPULA RADIAL, RESECCION CON IMPLANTE DE | $118.180 | $238.030 |
| 21-04-062-00 | — | ENDOPROTESIS TOTAL DE CODO, (CUALQUIER T | $314.190 | $358.830 |
| 21-04-063-00 | — | EPICONDILITIS, TRAT. QUIR. (CUALQUIER TE | $118.180 | $234.060 |
| 21-04-064-00 | — | LUXACION, REDUCCION CRUENTA | $118.180 | $259.680 |
| 21-04-065-00 | — | LUXOFRACTURA, REDUCCION CRUENTA C/S RESE | $395.590 | $254.190 |
| 21-04-066-00 | — | OSTEOSINTESIS EPITROCLEA-EPICONDILO (CUA | $118.180 | $236.850 |
| 21-04-067-00 | — | OSTEOSINTESIS OLECRANON U OSTEOSINTESIS | $118.180 | $250.670 |
| 21-04-068-00 | — | TRASLOCACION NERVIO CUBITAL (PROC. AUT.) | $118.180 | $276.830 |
| 21-04-069-00 | — | OPERACION DE SALVATAJE RADIO-PROCUBITO | $118.180 | $230.740 |
| 21-04-070-00 | — | AMPUTACION | $118.180 | $230.740 |
| 21-04-071-00 | — | EXTIRPACION METAFISIS DISTAL DEL CUBITO | $118.180 | $236.850 |
| 21-04-072-00 | — | LUXOFRACTURAS (MONTEGGIA-GALEAZZI), REDU | $118.180 | $250.670 |
| 21-04-073-00 | — | OSTEOSINTESIS, FRACT.CERRADA CUBITO Y/O | $118.180 | $250.670 |
| 21-04-074-00 | — | OSTEOTOMIA UNO O AMBOS HUESOS, C/S OSTES | $118.180 | $250.670 |
| 21-04-075-00 | — | PSEUDOARTROSIS CUBITO Y/O RADIO C/S OST | $118.180 | $236.850 |
| 21-04-076-00 | — | SINOSTOSIS RADIO-CUBITAL, TRAT. QUIR.,C/ | $118.180 | $230.740 |
| 21-04-077-00 | — | TRANSPLANTES MUSCULO-TENDINOSOS | $118.180 | $363.070 |
| 21-04-078-00 | — | CONTRACTURA ISQUEM.DE VOLKMANN:DESCENSO | $118.180 | $353.920 |
| 21-04-079-00 | — | ENDOPROTESIS TOTAL DE MUNECA, (CUALQUIER | $314.190 | $330.540 |
| 21-04-080-00 | — | ESTILOIDES CUBITAL,RADIAL,RESECCION DE | $118.180 | $204.340 |
| 21-04-081-00 | — | FRACTURA O PSEUDOARTROSIS ESCAFOIDES,TRA | $118.180 | $266.400 |
| 21-04-083-00 | — | LUXACION RADIOCARPIANA,TRAT. QUIR. | $118.180 | $250.670 |
| 21-04-084-00 | — | LUXACION SEMILUNAR,REDUCCION Y OSTEOSINT | $118.180 | $254.190 |
| 21-04-085-00 | — | OSTEOSINTESIS RADIO, (CUALQUIER TECNICA) | $118.180 | $250.670 |
| 21-04-086-00 | — | TENDOVAGINOSIS DE DE QUERVAIN,TRAT. QUIR | $118.180 | $230.860 |
| 21-04-087-00 | — | AMPUTACION DEDOS (TRES O MAS) | $118.180 | $254.100 |
| 21-04-088-00 | — | AMPUTACION DEDOS (UNO O DOS) | $26.270 | $200.720 |
| 21-04-089-00 | — | AMPUTACION MANO O DEL PULGAR | $118.180 | $276.830 |
| 21-04-090-00 | — | AMPUTACION PULPEJOS (PLASTIA KUTLER O SI | $26.270 | $204.340 |
| 21-04-091-00 | — | CONTRACTURA DUPUYTREN,TRAT. QUIR.,CADA T | $118.180 | $216.220 |
| 21-04-092-00 | — | CONTUSION-COMPRESION GRAVE,TRAT. QUIR.IN | $118.180 | $234.180 |
| 21-04-093-00 | — | DEDOS EN GATILLO,TRAT. QUIR.,CUALQUIER N | $26.270 | $210.300 |
| 21-04-094-00 | — | FLEGMON MANO, TRAT. QUIR. | $26.270 | $250.670 |
| 21-04-094-01 | — | FLEGMON MANO, TRAT. QUIR.1 CIRUJANO | $120.778 | $105.024 |
| 21-04-095-00 | — | LUXOFRACTURA METACARPOFALANGICA O INTERF | $26.270 | $236.850 |
| 21-04-096-00 | — | MANO REUMATICA EN RAFAGA: TRASLOCACIONES | $118.180 | $248.210 |
| 21-04-097-00 | — | MANO REUMATICA: IMPLANT. SILASTIC, CUALQ | $118.180 | $244.460 |
| 21-04-098-00 | — | MUTILACION GRAVE, ASEO.QUIR. COMPLETO C/ | $118.180 | $246.320 |
| 21-04-099-00 | — | OSTEOSINTESIS METACARPIANAS O DE FALANGE | $26.270 | $250.670 |
| 21-04-101-00 | — | PULGARIZACION DEDO (INDICE O ANULAR) | $118.180 | $349.820 |
| 21-04-102-00 | — | REIMPLANTE MANO O DEDO(S) | $314.190 | $870.610 |
| 21-04-103-00 | — | REPARACION FLEXORES: PRIMER TIEMPO ESPAC | $118.180 | $204.340 |
| 21-04-104-00 | — | REPARACION NERVIO DIGITAL CON INJERTO IN | $118.180 | $330.540 |
| 21-04-105-00 | — | RUPTURAS CERRADAS CAPSULO-LIGAMENT.O TEN | $118.180 | $250.670 |
| 21-04-106-00 | — | SUTURA NERVIO(S) DIGITAL(ES) MICROCIRU | $118.180 | $253.330 |
| 21-04-107-00 | — | TENORRAFIA EXTENSORES | $118.180 | $204.340 |
| 21-04-108-00 | — | TENORRAFIA O INJERTOS FLEXORES | $118.180 | $250.670 |
| 21-04-109-00 | — | TENOSINOVITIS SEPTICA, TRAT. QUIR. | $26.270 | $97.440 |
| 21-04-110-00 | — | TRANSPLANTE MICROQUIRURGICO PARA PULGAR | $314.190 | $540.560 |
| 21-04-111-00 | — | TRANSPOSICIONES TENDINOSAS FLEXORAS O EX | $118.180 | $250.670 |
| 21-04-112-00 | — | DIASTEMATOMIELIA,RESECCION ESPOLON C/S I | $314.190 | $630.270 |
| 21-04-113-00 | — | ESCOLIOSIS,TRAT.QUIR.,CUALQUIER VIA DE A | $530.150 | $870.610 |
| 21-04-116-00 | — | LUXACIONES,LUXOFRACTURAS VERTEBRALES (CE | $314.190 | $470.240 |
| 21-04-117-00 | — | OSTEOTOMIAS VERTEBRALES CORRECTORAS,C/S | $314.190 | $694.020 |
| 21-04-118-00 | — | PLASTIAS COSTALES,CUALQUIER NUMERO | $118.180 | $244.380 |
| 21-04-119-00 | — | REEMPLAZO CUERPO VERTEBRAL CON ARTRODESI | $314.190 | $1.006.530 |
| 21-04-121-00 | — | RESECCION DEL COXIS | $118.180 | $243.760 |
| 21-04-122-00 | — | DIASTASIS PUBIANA, TRAT. QUIR. | $118.180 | $383.840 |
| 21-04-123-00 | — | FRACTURA,OSTEOSINTESIS QUIR. | $118.180 | $348.990 |
| 21-04-124-00 | — | OSTEOTOMIA PELVIANA (SALTER,CHIARI O SIM | $118.180 | $363.490 |
| 21-04-125-00 | — | TRIPLE OSTEOTOMIA DE PELVIS | $118.180 | $391.710 |
| 21-04-126-00 | — | AMPUTACION INTER-ILIO ABDOMINAL | $530.150 | $509.840 |
| 21-04-127-00 | — | DESARTICULACION | $530.150 | $414.510 |
| 21-04-128-00 | — | ENDOPROTESIS PARCIAL C/S CEMENTACION (CU | $314.190 | $385.680 |
| 21-04-129-00 | — | ENDOPROTESIS TOTAL DE CADERA | $314.190 | $707.620 |
| 21-04-130-00 | — | EPIFISIOLISIS LENTA O AGUDA,TRAT. QUIR. | $118.180 | $353.920 |
| 21-04-131-00 | — | FRACTURA DE CUELLO DE FEMUR,OSTEOSINTESI | $314.190 | $304.980 |
| 21-04-132-00 | — | FRACTURA DE CUELLO DE FEMUR,RESECCION EP | $118.180 | $325.820 |
| 21-04-133-00 | — | LUXACION TRAUMATICA, REDUCCION CRUENTA | $118.180 | $343.090 |
| 21-04-134-00 | — | LUXOFRACTURA ACETABULAR,TRAT.QUIR. | $118.180 | $372.850 |
| 21-04-135-00 | — | OPERACION DE SALVATAJE CADERA, COLUMNA O | $314.190 | $528.590 |
| 21-04-136-00 | — | OSTEOTOMIAS FEMORALES | $118.180 | $343.090 |
| 21-04-137-00 | — | REDUCCION CRUENTA EN LUXACION CONGENITA | $118.180 | $343.090 |
| 21-04-138-00 | — | REDUCCION CRUENTA Y ACETABULOPLASTIA FEM | $314.190 | $414.510 |
| 21-04-139-00 | — | REDUCCION CRUENTA Y OSTEOTOMIA FEMORAL | $118.180 | $334.460 |
| 21-04-140-00 | — | TENOTOMIA ADUCTORES C/S BOTAS, CON YUGO | $118.180 | $236.850 |
| 21-04-141-00 | — | TROCANTEROPLASTIAS | $118.180 | $363.070 |
| 21-04-142-00 | — | AMPUTACION | $118.180 | $284.820 |
| 21-04-143-00 | — | EPIFISIODESIS (FEMUR Y/O TIBIA) | $118.180 | $250.450 |
| 21-04-144-00 | — | OSTEOSINTESIS DIAFISIARIA O METAFISIARIA | $118.180 | $251.740 |
| 21-04-145-00 | — | OSTEOTOMIA CORRECTORA | $118.180 | $252.060 |
| 21-04-146-00 | — | OSTEOTOMIA DE ALARGAMIENTO O ACORTAMIENT | $314.190 | $321.940 |
| 21-04-147-00 | — | OSTEOTOMIA EN ROSARIO CON ENCLAVIJAMIENT | $314.190 | $334.460 |
| 21-04-148-00 | — | PSEUDOARTROSIS ,TRAT.QUIR. (CUALQUIER TE | $118.180 | $374.190 |
| 21-04-149-00 | — | RUPTURA Y/O HERNIA MUSCULAR,TRAT.QUIR. | $118.180 | $244.380 |
| 21-04-150-00 | — | ARTROTOMIA POR CUERPOS LIBRES,OSTEOCONDR | $118.180 | $250.670 |
| 21-04-151-00 | — | DESARTICULACION | $314.190 | $252.060 |
| 21-04-152-00 | — | DISFUNCION PATELO-FEMORAL,REALINEAMIENTO | $118.180 | $284.880 |
| 21-04-153-00 | — | ENDOPROTESIS TOTAL DE RODILLA, (CUALQUIE | $314.190 | $630.270 |
| 21-04-154-00 | — | FRACTURA ROTULA: OSTEOSINTESIS O PATELEC | $118.180 | $243.760 |
| 21-04-155-00 | — | FRACTURAS CONDILEAS O DE PLATILLOS TIBIA | $118.180 | $272.800 |
| 21-04-156-00 | — | INESTABILIDAD CRONICA DE RODILLA, RECONS | $118.180 | $386.670 |
| 21-04-157-00 | — | LUXACION O ROTURA LIGAMENTOS, TRAT.QUIR. | $118.180 | $240.210 |
| 21-04-158-00 | — | MENISCECTOMIA QUIRURGICA, INTERNA Y/O EX | $118.180 | $240.210 |
| 21-04-159-00 | — | MENISCECTOMIA U OTRAS INTERVENCIONES POR | $118.180 | $386.670 |
| 21-04-160-00 | — | QUISTE POPLITEO, TRAT.QUIR. | $26.270 | $230.860 |
| 21-04-161-00 | — | RECONSTRUCCION APARATO EXTENSOR | $118.180 | $254.190 |
| 21-04-162-00 | — | REPARACION QUIRURGICA LIGAMENTOS COLATER | $118.180 | $353.090 |
| 21-04-163-00 | — | TRASLOCACIONES MUSCULO-TENDINOSAS EN ROD | $118.180 | $334.460 |
| 21-04-164-00 | — | AMPUTACION | $118.180 | $252.190 |
| 21-04-165-00 | — | COLGAJO CRUZADO DE PIERNA,TRAT.QUIR.COMP | $118.180 | $304.980 |
| 21-04-166-00 | — | FASCIOTOMIA POR SINDROME COMPARTAMENTAL | $118.180 | $238.030 |
| 21-04-167-00 | — | OSTEOSINTESIS TIBIO-PERONE (CUALQUIER T | $118.180 | $250.670 |
| 21-04-168-00 | — | OSTEOTOMIA CORRECTORA DE EJES (CUALQUIE | $118.180 | $250.450 |
| 21-04-169-00 | — | OSTEOTOMIA DE ALARGAMIENTO O ACORTAMIENT | $314.190 | $331.040 |
| 21-04-170-00 | — | OSTEOTOMIA DEL PERONE | $118.180 | $199.180 |
| 21-04-171-00 | — | PERONE PROTIBIA | $118.180 | $238.300 |
| 21-04-172-00 | — | PSEUDOARTROSIS, C/S OSTEOSINTESIS (CUAL | $118.180 | $250.450 |
| 21-04-173-00 | — | DESARTICULACION | $314.190 | $224.770 |
| 21-04-174-00 | — | ENDOPROTESIS TOTAL TOBILLO, (CUALQUIER T | $314.190 | $382.350 |
| 21-04-175-00 | — | ESGUINCE GRAVE,TRAT.QUIR. CAPSULO-LIGAME | $118.180 | $250.670 |
| 21-04-176-00 | — | FRACTURA ASTRAGALO Y/O CALCANEO,OSTEOSIN | $118.180 | $250.450 |
| 21-04-177-00 | — | HUESOS SUPERNUMERARIOS,EXTIRPACION, UNO | $118.180 | $236.850 |
| 21-04-178-00 | — | LUXACION TIBIO-ASTRAG.-CALCAN., REDUCC. | $118.180 | $247.780 |
| 21-04-179-00 | — | LUXOFRACTURA TOBILLO, CUALQUIER TIPO, OS | $118.180 | $300.510 |
| 21-04-180-00 | — | OSTEOPLASTIA TIBIO-CALCANEA | $118.180 | $237.440 |
| 21-04-181-00 | — | RUPTURA TENDON DE AQUILES O TIBIAL POSTE | $118.180 | $236.690 |
| 21-04-182-00 | — | RUPTURA TIBIAL ANTERIOR U OTROS,TENORRAF | $118.180 | $243.760 |
| 21-04-183-00 | — | TENORRAFIA EXTENSORES O TENOTOMIA DE ALA | $118.180 | $254.190 |
| 21-04-184-00 | — | TRASLOCACION TENDINOSA | $118.180 | $254.190 |
| 21-04-185-00 | — | AMPUTACION TRANSMETATARSIANA | $118.180 | $237.440 |
| 21-04-186-00 | — | ASTRAGALO VERTICAL, TRAT. QUIR. | $118.180 | $260.060 |
| 21-04-187-00 | — | ESPOLON CALCANEO,TRAT.QUIR. | $118.180 | $199.180 |
| 21-04-188-00 | — | EXOSTOSIS 5ø METATARSIANO,("JUANETILLO") | $118.180 | $216.220 |
| 21-04-189-00 | — | FASCIOTOMIA PLANTAR (PROC.AUT.) | $118.180 | $230.860 |
| 21-04-190-00 | — | HALLUX VALGUS O RIGIDUS,TRAT.QUIR. COMPL | $118.180 | $254.190 |
| 21-04-191-00 | — | LUXACIONES,LUXOFRACTURAS,FRACTURAS, REDU | $118.180 | $247.220 |
| 21-04-192-00 | — | MAL PERFORANTE PLANTAR,TRAT.QUIR. | $118.180 | $240.960 |
| 21-04-193-00 | — | NEUROMA DE MORTON,TRAT.QUIR. | $118.180 | $210.300 |
| 21-04-194-00 | — | ORTEJOS EN GARRA,TRAT.QUIR.,CUALQ.NUMERO | $118.180 | $216.220 |
| 21-04-195-00 | — | ORTEJOS,AMPUTACION,UNO O MAS DEL MISMO P | $118.180 | $205.010 |
| 21-04-196-00 | — | PIE BOT U OTRAS MALFORMACIONES CONGENITA | $118.180 | $252.060 |
| 21-04-197-00 | — | PIE CAVO, TRAT.QUIR. (CUALQUIER TECNICA) | $118.180 | $234.180 |
| 21-04-198-00 | — | PIE PLANO, TRAT. QUIR. (CUALQUIER TECNIC | $118.180 | $240.210 |
| 21-04-199-00 | — | PIE REUMATOIDEO, TRAT.QUIR.COMPLETO (CUA | $118.180 | $241.980 |
| 21-04-200-00 | — | SESAMOIDEOS,EXTIRPACION DE UNO O MAS DEL | $118.180 | $227.580 |
| 21-04-201-00 | — | TENORRAFIA EXTENSORES | $118.180 | $236.850 |
| 21-04-202-00 | — | TRANSPLANTES TENDINOSOS (CUALQUIER TECNI | $118.180 | $254.190 |
| 21-05-001-00 | — | CALZON CORTO DE YESO | $56.670 | $36.420 |
| 21-05-004-00 | — | RODILLERA, BOTA LARGA O CORTA DE YESO | $45.290 | $29.100 |
| 21-05-005-00 | — | VELPEAU | $45.290 | $29.100 |
| 21-05-006-00 | — | YESO ANTEBRAQUIAL C/S FERULA DIGITAL | $45.290 | $29.100 |
| 21-05-007-00 | — | YESO BRAQUICARPIANO | $45.290 | $29.100 |
| 21-05-008-00 | — | YESO PELVIPEDIO BILATERAL | $109.290 | $70.220 |
| 21-05-009-00 | — | YESO PELVIPEDIO UNILATERAL | $86.080 | $55.310 |
| 21-05-010-00 | — | YESO TORACOBRAQUIAL | $79.280 | $50.940 |
| 21-05-011-00 | — | CORSETS DE MILWAUKEE O SIMILARES (INCLUY | $93.230 | $59.900 |
| 21-06-001-00 | — | RETIRO DE ENDOPROTESIS U OSTEOSINTESIS I | $314.190 | $244.140 |
| 21-06-002-00 | — | RETIRO DE PLACAS RECTAS O ANGULADAS | $118.180 | $250.400 |
| 21-06-003-00 | — | RETIRO DE TORNILLOS, CLAVOS, AGUJAS DE O | $118.180 | $95.100 |
| 21-07-001-00 | — | LUXACIONES DE ARTICULACIONES MEDIANAS(HO | $172.060 | $110.560 |
| 21-07-002-00 | — | LUXACIONES DE ARTICULACIONES MAYORES (C | $26.270 | $144.240 |
| 21-07-003-00 | — | LUXACIONES DE ARTICULACIONES MENORES (EL | $77.890 | $50.050 |
| 21-07-004-00 | — | FRACTURAS MAYORES (COLUMNA, PELVIS, SUPR | $26.270 | $196.260 |
| 21-07-005-00 | — | FRACTURAS MEDIANAS (DIAFISIS HUMERAL, RA | $252.540 | $162.270 |
| 21-07-006-00 | — | FRACTURAS MENORES (EL RESTO) | $123.010 | $79.040 |
| 21-07-007-00 | — | TRATAMIENTO FUNCIONAL CON TECNICA DE SAR | $26.270 | $139.740 |
| 21-07-008-00 | — | TRATAMIENTO FUNCIONAL CON TECNICA DE SAR | $26.270 | $121.540 |
| 21-07-009-00 | — | LUXACION CONGENITA DE CADERA, TRAT. ORTO | $26.270 | $121.950 |
| 21-07-010-00 | — | PIE BOT, CADA PIE, HASTA 10 CAMBIOS DE Y | $26.270 | $129.950 |
| 22-01-001-00 | — | ANESTESIA GENERAL O REGIONAL OTORGADA PO | $97.480 | $62.640 |
| 22-01-002-00 | — | ANESTESIA PERIDURAL CONTINUA, PROC. AUT. | $117.380 | $75.420 |
| 22-01-004-00 | — | SEDACION CISTOSCOPIA | $97.480 | $62.640 |
| 22-01-100-00 | — | SEDACION ENDOSCOPIA DIGESTIVA SUPERIOR | $80.000 | $80.000 |
| 22-01-101-00 | — | SEDACION COLONOSCOPIA | $90.000 | $90.000 |
| 22-01-102-00 | — | SEDACION ENDOSCOPIA SUPERIOR E INFERIOR | $98.000 | $98.000 |
| 22-01-103-00 | — | SEDACION ECOCARDIOGRAFIA | $70.000 | $80.000 |
| 22-10-100-00 | — | INSTALACION CATETER TERAPIA DOLOR | $80.000 | $80.000 |
| 22-10-110-00 | — | TERAPIA ENDOVENOSA DOLOR | $80.000 | $80.000 |
| 23-01-001-00 | — | ENMASCARADOR DE TINNITUS | No disponible | $134.110 |
| 23-01-002-00 | — | ORTESIS CERVICALES (COLLARES BLANDOS Y D | No disponible | $14.930 |
| 23-01-003-00 | — | PROTESIS DE OREJA | No disponible | $76.790 |
| 23-01-004-00 | — | PROTESIS METALICA MANDIBULA INFERIOR | No disponible | $106.210 |
| 23-01-005-00 | — | PROTESIS OCULAR (NO INCLUYE LENTES INTRA | No disponible | $137.650 |
| 23-01-006-00 | — | PROTESIS PARA CRANEOPLASTIA | No disponible | $76.790 |
| 23-01-007-00 | — | PROTESIS PARA HIDROCEFALIA | No disponible | $224.630 |
| 23-01-008-00 | — | BRAGUERO | No disponible | $8.570 |
| 23-01-010-00 | — | CABLES ELECTRODOS | No disponible | $42.680 |
| 23-01-011-00 | — | FAJA ORTOPEDICA | No disponible | $13.750 |
| 23-01-012-02 | — | INSTALACION SONDA MARCAPASO | $235.050 | $235.050 |
| 23-01-013-00 | — | PROTESIS ABDOMINAL (PARA EVENTRACION) | No disponible | $27.550 |
| 23-01-014-00 | — | PROTESIS MAMARIA C/U | No disponible | $98.300 |
| 23-01-015-00 | — | PROTESIS TESTICULAR, C/U | No disponible | $42.680 |
| 23-01-016-00 | — | PROTESIS ARTERIAL | No disponible | $115.300 |
| 23-01-017-00 | — | VALVULA AORTICA | No disponible | $436.790 |
| 23-01-018-00 | — | VALVULA MITRAL | No disponible | $520.010 |
| 23-01-019-00 | — | VALVULA TRICUSPIDE | No disponible | $436.790 |
| 23-01-020-00 | — | ORTESIS, MUSLO-PIE (ISQUIOPEDIO) | No disponible | $48.400 |
| 23-01-021-00 | — | ARNES DE PROTESIS | No disponible | $7.300 |
| 23-01-022-00 | — | BASTON CANADIENSE O TRIPODE, C/U | No disponible | $14.110 |
| 23-01-023-00 | — | CAVIDAD PARA AMPUTADO DE MUSLO | No disponible | $29.900 |
| 23-01-024-00 | — | RODILLERA | No disponible | $4.030 |
| 23-01-025-00 | — | CASQUETE DE GOMA | No disponible | $12.130 |
| 23-01-026-00 | — | CINTURON PARA PROTESIS | No disponible | $9.780 |
| 23-01-027-00 | — | CINTURON PELVICO DOBLE | No disponible | $56.440 |
| 23-01-028-00 | — | CLAVOS (POR UNIDAD) | No disponible | $11.580 |
| 23-01-029-00 | — | COJIN DE ABDUCCION O PAULIK | No disponible | $7.300 |
| 23-01-031-00 | — | CORREA DE MULEY | No disponible | $7.110 |
| 23-01-032-00 | — | ORTESIS DE COLUMNA (MILWAUKEE, TAYLOR O | No disponible | $92.380 |
| 23-01-033-00 | — | ORTESIS LUMBOSACRA (CORSET DE KNIGHT) | No disponible | $35.450 |
| 23-01-034-00 | — | ORTESIS PALMAR ACTIVA (UCLA) | No disponible | $10.670 |
| 23-01-035-00 | — | ORTESIS RADIAL DE POSICION | No disponible | $10.930 |
| 23-01-036-00 | — | ORTESIS CORTA DE POSICION (DIGITALES) C/ | No disponible | $6.860 |
| 23-01-037-00 | — | ORTESIS DE USO NOCTURNO DE MIEMBRO INFER | No disponible | $20.170 |
| 23-01-038-00 | — | ORTESIS LARGA DE POSICION | No disponible | $9.890 |
| 23-01-039-00 | — | INSTRUMENTAL PARA FIJACION DE COLUMNA (H | No disponible | $59.730 |
| 23-01-040-00 | — | MULETAS (PAR) | No disponible | $12.130 |
| 23-01-041-00 | — | ORTESIS LARGA BILATERAL CON CINTURON PEL | No disponible | $106.850 |
| 23-01-042-00 | — | ORTESIS LARGA UNILATERAL | No disponible | $76.790 |
| 23-01-043-00 | — | ORTESIS MANO-MUNECA PASIVA | No disponible | $4.130 |
| 23-01-044-00 | — | ORTESIS PARA RODILLA | No disponible | $31.500 |
| 23-01-045-00 | — | ORTESIS TOBILLO-PIE | No disponible | $40.330 |
| 23-01-046-00 | — | P.T.B. O P.T.S. | No disponible | $275.160 |
| 23-01-047-00 | — | PIE PROTESICO | No disponible | $35.450 |
| 23-01-048-00 | — | PILON REDUCCION MUSLO | No disponible | $110.050 |
| 23-01-049-00 | — | PILON REDUCCION PIERNA | No disponible | $39.310 |
| 23-01-050-00 | — | PLACAS | No disponible | $7.720 |
| 23-01-051-00 | — | PROTESIS BAJO CODO CON GANCHO, MANO Y GU | No disponible | $235.880 |
| 23-01-052-00 | — | PROTESIS BAJO RODILLA, CON CORSELETE | No disponible | $201.600 |
| 23-01-053-00 | — | PROTESIS DE CODO | No disponible | $149.770 |
| 23-01-054-00 | — | PROTESIS DE MANO (HUESOS) | No disponible | $207.980 |
| 23-01-055-00 | — | PROTESIS DE RODILLA | No disponible | $298.680 |
| 23-01-056-00 | — | PROTESIS DESARTICULADO RODILLA | No disponible | $196.530 |
| 23-01-057-00 | — | PROTESIS DESARTICULADO DE CADERA CON BLO | No disponible | $393.100 |
| 23-01-058-00 | — | PROTESIS DESARTICULADO DE CODO CON GANCH | No disponible | $314.530 |
| 23-01-059-00 | — | PROTESIS DESARTICULADO DE HOMBRO CON GAN | No disponible | $332.850 |
| 23-01-060-00 | — | PROTESIS PARCIAL DE CADERAS | No disponible | $63.980 |
| 23-01-061-00 | — | PROTESIS PARA AMPUTACION PARCIAL DE PIE | No disponible | $196.530 |
| 23-01-062-00 | — | PROTESIS SOBRE RODILLA C/S BLOQUEO | No disponible | $201.600 |
| 23-01-063-00 | — | PROTESIS SOBRE RODILLA CON RODILLA DE SE | No disponible | $267.150 |
| 23-01-064-00 | — | PROTESIS TIPO SYME | No disponible | $112.370 |
| 23-01-065-00 | — | PROTESIS TOTAL DE CADERAS | No disponible | $106.720 |
| 23-01-067-00 | — | TALONERA GOMA (PAR) | No disponible | $19.670 |
| 23-01-068-00 | — | TORNILLOS (POR UNIDAD) | No disponible | $2.180 |
| 23-01-069-00 | — | PROTESIS CANULA PARA TRAQUEOTOMIA | No disponible | $14.540 |
| 23-01-070-00 | — | PROTESIS PARA LARINGECTOMIA | No disponible | $27.550 |
| 23-01-072-00 | — | PLANTILLAS ORTOPEDICAS (PAR) | No disponible | $12.870 |
| 23-01-080-00 | — | LENTE INTRAOCULAR. | $145.780 | $136.130 |
| 23-01-081-00 | — | AUDIFONOS (SOLO PARA MAYORES DE 55 ANOS) | No disponible | $192.690 |
| 26-01-001-00 | — | ATENCIONES DE ENFERMERIA A/P | $20.500 | $20.500 |
| 26-01-002-00 | — | ATENCION INTEGRAL DE ENFERMERIA EN DOMIC | No disponible | $17.750 |
| 26-01-003-00 | — | ATENCION INTEGRAL DE ENFERMERIA EN DOMIC | $28.600 | $18.250 |
| 26-01-009-00 | — | CONTROL DE PRESION ARTERIAL | $2.500 | $2.500 |
| 26-01-017-00 | — | FLEBOCLISIS PEDIATRICA | $24.750 | $24.750 |
| 26-01-101-00 | — | CUIDADORA MQ | $39.000 | $39.000 |
| 26-01-102-00 | — | CUIDADORA HORARIO INHABIL | $50.700 | $50.700 |
| 26-01-104-00 | — | REHABILITACION CARDIACA POR SESION | $35.000 | $35.000 |
| 26-10-001-00 | — | EXTRACCION DE PUNTOS | $9.100 | $9.100 |
| 26-10-002-00 | — | CURACION SIMPLE | $16.500 | $16.500 |
| 26-10-003-00 | — | CURACION MEDIANA | $26.400 | $26.400 |
| 26-10-004-00 | — | CURACION COMPLEJA | $39.600 | $39.600 |
| 26-10-005-00 | — | INSTALACION SONDA FOLEY | $24.750 | $24.750 |
| 26-10-005-01 | — | INSTALACION SONDA FOLEY SILICONA | $36.300 | $36.300 |
| 26-10-006-00 | — | TRATAMIENTO E.V. (NO INCLUYE FARMACOS) | $9.900 | $9.900 |
| 26-10-007-00 | — | TRAT.INTRAMUSCULAR (NO INCLUYE FARMACOS) | $6.600 | $6.600 |
| 26-10-008-00 | — | ENFERMERIA PROCEDIMIENTOS GENERALES | $13.200 | $13.200 |
| 26-10-009-00 | — | CONTROL PRESION ARTERIAL EN CONSULTORIO | $2.200 | $2.200 |
| 26-10-013-00 | — | ASPIRACION DE SECRECIONES A/P | $4.950 | $4.950 |
| 26-10-016-00 | — | FLEBOCLISIS ADULTO | $24.750 | $24.750 |
| 26-10-019-00 | — | NEBULIZACION A/P | $13.200 | $13.200 |
| Código CHP | Nombre prestación | Valor particular | Valor Fonasa |
|---|---|---|---|
| 70-10-009-00 | VACUNA TWINRIX ADULTO | $59.820 | $59.820 |
| 70-10-010-00 | VACUNA VARILRIX | $27.800 | $27.800 |
| 70-10-014-00 | HAVRIX | $30.960 | $30.960 |
| 70-10-015-00 | VACUNA TRIVIRICA | $4.500 | $4.500 |
| 70-10-017-00 | PREVENAR | $66.000 | $66.000 |
| 70-10-018-00 | VACUNA ROTARIX | $84.890 | $84.890 |
| 70-10-019-00 | VACUNA CERVARIX | $51.350 | $51.350 |
| 70-10-020-00 | VACUNA SYNFLORIX | $51.400 | $51.400 |
| 70-10-021-00 | VACUNA HERBIOVAC | $15.000 | $15.000 |
| 70-10-022-00 | VACUNA FIEBRE AMARILLA | $45.000 | $45.000 |
| 70-10-024-00 | VACUNA HEPATITIS B ENGERIX | $30.345 | $30.345 |
| 70-10-025-00 | VACUNA MENACTRA | $59.753 | $59.753 |
| 70-10-027-00 | HEXAXIM | $63.430 | $63.430 |
| 70-10-030-00 | VACUNA BEXERO | $113.740 | $113.740 |
| 70-10-031-00 | VACUNA MENVEO 0.5ML | $88.790 | $88.790 |
| 70-10-032-00 | VACUNA ROTATEQ | $42.200 | $42.200 |
| 70-10-033-00 | VACUNA VARIVAX | $30.000 | $30.000 |
| 70-10-034-00 | VACUNA AVAXIM | $23.200 | $23.200 |
| 70-10-035-00 | VACUNA GARDASIL 9 | $146.000 | $146.000 |
| 70-10-050-00 | VACUNA RECOMVAX (ANTI HEPATITIS B) | $12.000 | $12.000 |
| 70-20-001-00 | PIELOGRAFIA INSUMOS | $23.775 | $23.775 |
| 70-20-001-01 | INSUMOS PIELOGRAFIA ADULTOS + DE 75 KG | $44.850 | $44.850 |
| 70-20-002-01 | ENEMA BARITADO EN ADULTO MAYOR (INSUMOS) | $13.203 | $13.203 |
| 70-20-003-00 | ENEMA BARITADO NIÑOS (INSUMOS) | $10.680 | $10.680 |
| 70-20-004-00 | URETROCISTOGRAFIA ADULTOS (INSUMOS) | $43.500 | $43.500 |
| 70-20-005-00 | URETROCISTOGRAFIA NIÑOS INSUMOS | $27.276 | $27.276 |
| 70-20-006-00 | HISTEROSALPINGOGRAFIA INSUMOS | $22.260 | $22.260 |
| 70-20-007-00 | INSUMOS BIOPSIA CORE MAMARIA | $60.750 | $60.750 |
| 70-20-008-00 | INSUMOS COLANGIOGRAFIA POST OPERATORIA | $20.690 | $20.690 |
| 70-20-010-00 | INSUMOS ELECTROMIOGRAFIA | $22.000 | $22.000 |
| 70-20-011-00 | INSUMOS EN EED EN ADULTOS | $1.000 | $1.000 |
| 70-20-012-00 | INSUMOS FISTULOGRAFIA | $21.600 | $21.600 |
| 70-20-013-00 | INSUMOS CIRUGIA MENOR 1 | $18.000 | $18.000 |
| 70-20-014-00 | INSUMOS CIRUGIA MENOR 2 | $24.000 | $24.000 |
| 70-20-015-00 | INSUMOS EN PUNCION TIROIDEA | $7.500 | $7.500 |
| 70-20-015-01 | INSUMOS EN PUNCION MAMARIA | $7.500 | $7.500 |
| 70-20-015-02 | INSUMOS PUNCION PLEURAL | $7.500 | $7.500 |
| 70-20-016-00 | INSUMOS FIBROBRONCOSCOPIA | $37.500 | $37.500 |
| 70-20-017-00 | INSUMOS YESO BOTA CORTA CON TACO | $34.920 | $34.920 |
| 70-20-018-00 | INSUMOS YESO BOTA CORTA SIN TACO | $25.200 | $25.200 |
| 70-20-020-00 | INSUMOS YESO BOTA LARGA SIN TACO | $40.680 | $40.680 |
| 70-20-020-01 | INSUMOS YESO PLASTICO BOTA LARGA C/ZAPAT | $69.840 | $69.840 |
| 70-20-021-00 | INSUMOS YESO RODILLERA | $32.940 | $32.940 |
| 70-20-021-01 | INSUMOS YESO PLASTICO RODILLERA | $43.560 | $43.560 |
| 70-20-022-00 | INSUMOS YESO BRAQUICARPIANO CON FERULA | $34.380 | $34.380 |
| 70-20-022-01 | INSUMOS YESO PLASTICO BRAQUICARPIANO | $46.440 | $46.440 |
| 70-20-023-00 | INSUMOS YESO ANTEBRAQUIAL | $20.520 | $20.520 |
| 70-20-024-00 | INSUMOS YESO BRAQUCARPIANO S/FERULA | $27.720 | $27.720 |
| 70-20-024-01 | INSUMOS YESO PLASTICO ANTEBRAQUIAL | $25.200 | $25.200 |
| 70-20-024-02 | INSUMOS YESO TORACOBRAQUIAL | $50.400 | $50.400 |
| 70-20-025-00 | INSUMOS BOTA CORTA PLASTICO C/ZAPATO | $39.000 | $39.000 |
| 70-20-026-00 | INSUMOS BIOPSIA OSEA | $122.000 | $122.000 |
| 70-20-027-00 | LENTE INTRAOCULAR( LIO) | $204.306 | $204.306 |
| 70-20-029-00 | INSTALACION SONDA NASOYEYUNAL | $37.500 | $37.500 |
| 70-20-030-00 | FERULA DIGITAL | $1.500 | $1.500 |
| 70-20-031-00 | FERULA DIGITAL COMPLETA | $6.300 | $6.300 |
| 70-20-032-00 | INSUMOS EN INFILTRACION | $2.250 | $2.250 |
| 70-20-033-00 | INSUMOS EN EXTRACCION DE PUNTOS | $4.500 | $4.500 |
| 70-20-034-00 | INSUMOS PARA CURACION | $4.500 | $4.500 |
| 70-20-035-00 | MASCARILLA NEBULIZACIÓN | $10.560 | $10.560 |
| 70-20-036-00 | TEGADERM MEDIANO | $2.100 | $2.100 |
| 70-20-037-00 | TEGADERM GRANDE | $3.660 | $3.660 |
| 70-20-038-00 | GASA PARAFINADA | $1.050 | $1.050 |
| 70-20-039-00 | STERI-STRIP | $2.160 | $2.160 |
| 70-20-040-00 | SULFADIAZINA DE PLATA | $12.300 | $12.300 |
| 70-20-041-00 | TAPON NASAL MEROCEL | $19.200 | $19.200 |
| 70-20-042-00 | PENROSE | $1.095 | $1.095 |
| 70-20-043-00 | ELASTOMUL | $900 | $900 |
| 70-20-044-00 | INSUMOS BIOPSIA CORE TRANSRECTAL O PROST | $43.500 | $43.500 |
| 70-20-045-00 | INSUMOS BIOPSIA ENDOMETRIO | $28.000 | $28.000 |
| 70-20-051-00 | INSUMOS SONDA NASOYEYUNAL BAJO RADIOSC | $37.500 | $37.500 |
| 70-20-052-00 | INSUMOS BIOPSIA CORE ABDOMINAL | $43.500 | $43.500 |
| 70-20-053-00 | INSUMO BIOPSIA DE TIROIDES | $43.500 | $43.500 |
| 70-20-054-00 | MALLA EN CIRUGÍA HERNIA | No disponible | $36.000 |
| 70-20-056-00 | INSUMOS INFILTRACION INTRATECAL | $37.500 | $37.500 |
| 70-20-057-00 | INSUMOS Y FARMACIA LASIK | $120.000 | No disponible |
| 70-20-058-00 | INSUMOS CIRUGIA OFTALMOLOGICA 1 | $45.500 | $45.500 |
| 70-20-060-00 | FACTOR COAGULACION (UNIDAD) | $356.800 | $356.800 |
| 70-20-062-00 | INSUMOS COLPOSCOPIA | $4.500 | $4.500 |
| 70-20-063-00 | INSUMOS NORPLANT | $10.000 | $10.000 |
| 70-20-064-00 | INSUMOS CRIOTERAPIA | $10.000 | $10.000 |
| 70-20-065-00 | INSUMOS HISTEROSONOGRAFIA | $11.200 | $11.200 |
| 70-20-066-00 | INSUMOS AMNIOCENTESIS | $7.500 | $7.500 |
| 70-20-067-00 | INSUMOS EXTRACCION POLIPOS | $251.800 | $251.800 |
| 70-20-068-00 | INSUMOS ECOCARDIOGRAMA TRANSESOFAGICO | $13.000 | $13.000 |
| 70-20-069-00 | COPIA RM ,TAC, ECO | $20.000 | $20.000 |
| 70-20-071-00 | TAPON LAGRIMAL | $64.431 | $64.431 |
| 70-20-072-00 | SET GASTROSTOMIA PERCUTANEO 24 FR 1 UNID | $175.680 | $175.680 |
| 70-20-073-00 | SONDA GASTROSTOMIA Nº24 | $118.650 | $118.650 |
| 70-20-075-00 | INSUMOS ENDOSCOPIA | $30.000 | $30.000 |
| 70-20-083-00 | INSUMOS ANESTESIA GENERAL TAC/RM | $75.000 | $75.000 |
| 70-20-084-00 | PREMEDICACION ADULTOS RX | $14.100 | $14.100 |
| 70-20-085-00 | PREMEDICACION PEDIATRICO RX | $9.400 | $9.400 |
| 70-20-090-00 | INSUMOS GTT | $229.876 | $229.876 |
| 70-20-091-00 | INSUMOS BIOPSIA RENAL | $85.402 | $85.402 |
| 70-20-092-00 | INSUMOS FENO | $14.600 | $14.600 |
| 70-20-100-00 | INSUMOS CAPSULOTOMIA | $28.510 | $28.510 |
| 70-20-101-00 | AVASTIN | $67.973 | $67.973 |
| 70-20-102-00 | INSUMOS BIOPSIA PARTES BLANDAS | $87.500 | $87.500 |
| 70-20-103-00 | INSUMOS TRABECULOPLASTIA | $25.500 | $25.500 |
| 70-20-104-00 | INSUMOS IRIDOTOMIA | $24.900 | $24.900 |
| 70-20-105-00 | INSUMOS PUNCION SEROMA | $7.500 | $7.500 |
| 70-20-110-00 | INSUMOS BIOPSIA PROSTATICA | $135.000 | $135.000 |
| 70-20-111-00 | INSUMOS ARTROTAC I | $10.487 | $10.487 |
| 70-20-112-00 | INSUMOS ARTROTAC II | $28.527 | $28.527 |
| 70-20-120-00 | INSUMOS PUNCION DIAGNOSTICA | $1.990 | $1.990 |
| 70-20-121-00 | INSUMOS ADMINISTRACION FERRINJECT | $9.000 | $9.000 |
| 70-20-130-00 | INSUMOS PUNCION MEDULAR | $90.000 | $90.000 |
| 70-20-140-00 | INSUMOS DRENAJE PERCUTANEO | $116.300 | $116.300 |
| 70-20-150-00 | INSUMOS BLOQUEO PERIFERICO | $50.000 | $50.000 |
| 70-20-170-00 | INSUMOS SEDACION ENDOSCOPIA | $54.000 | $54.000 |
| 70-20-180-00 | INSUMO LAB TEC RAPIDA | $17.000 | $17.000 |
| 70-20-181-00 | INSUMOS CISTOSCOPIA AMBULATORIA | $79.209 | $79.209 |
| 70-20-190-00 | INSUMOS CISTOMETRIA | $10.000 | $10.000 |
| 70-20-400-00 | INSUMOS TERAPIA ENDOVENOSA DOLOR | $12.555 | $12.555 |
| 70-30-001-00 | MEDIO DE CONTRASTE TAC SET 1 | $29.250 | $29.250 |
| 70-30-002-00 | MEDIO DE CONTRASTE TAC SET 2 | $32.000 | $32.000 |
| 70-30-003-00 | MEDIO DE CONTRASTE SET 3 | $53.300 | $53.300 |
| 70-30-004-00 | VISIPAQUE SIMPLE | $37.500 | $37.500 |
| 70-30-005-00 | VISIPAQUE DOBLE | $51.000 | $51.000 |
| 70-30-006-00 | SET CONTRASTE TAC CEREBRO | $18.550 | $18.550 |
| 70-30-007-00 | SEDACION EN SCANNER (1) | $110.000 | $110.000 |
| 70-30-008-00 | SEDACION RM (1) | $120.000 | $120.000 |
| 70-30-009-00 | SEDACION SCANNER (2) | $140.000 | $140.000 |
| 70-30-010-00 | SEDACION RM (2) | $160.000 | $160.000 |
| 70-30-011-00 | SEDACION RM (3) | $210.000 | $210.000 |
| 70-30-012-00 | SEDACION SCANNER (3) | $180.000 | $180.000 |
| 70-30-021-00 | INSUMOS BIOPSIA PERCUTANEA | $119.787 | $119.787 |
| 70-30-101-00 | RM CONTRASTE | $28.000 | $28.000 |
| 70-30-118-00 | GASTROVIEW | $23.240 | $23.240 |
| 70-40-001-00 | GLUCOSA ORAL | $3.300 | $3.300 |
| 70-40-002-00 | SIMPLATE | $4.250 | $4.250 |
| 70-40-003-00 | RECOLECTOR ORINA | $1.800 | $1.800 |
| 70-40-004-00 | RECOLECTOR 24 HORAS | $1.500 | $1.500 |
| 70-40-005-00 | SET PORTA OBJETOS | $750 | $750 |
| 70-40-006-00 | FRASCOS EXAMENES | $750 | $750 |
| 70-40-007-00 | SONDA | $1.800 | $1.800 |
| 70-40-008-00 | ESTUCHE REACTIVO (HEMORRAGIAS OCULTAS) | $2.250 | $2.250 |
| 70-40-009-00 | BOLSA DE SANGRE | $4.500 | $4.500 |
| 70-40-010-00 | FRASCO HEMOCULTIVO | $8.585 | $8.585 |
| 70-50-001-00 | BOTA CORTA ADULTO | $30.600 | $30.600 |
| 70-50-002-00 | BOTA CORTA PEDIATRICO | $25.200 | $25.200 |
| 70-50-003-00 | BOTA LARGA ADULTO | $37.800 | $37.800 |
| 70-50-004-00 | BOTA LARGA PEDIATRICO | $30.600 | $30.600 |
| 70-50-005-00 | RODILLERA Y/O VALVA ADULTO | $57.600 | $57.600 |
| 70-50-006-00 | RODILLERA Y/O VALVA PEDIATRICO | $45.000 | $45.000 |
| 70-50-007-00 | VALVA ABP ADULTO | $30.600 | $30.600 |
| 70-50-008-00 | VALVA ABP PEDIATRICO | $2.700 | $2.700 |
| 70-50-009-00 | VALVA B/C ADULTO | $23.400 | $23.400 |
| 70-50-010-00 | VALVA B/C PEDIATRICO | $19.800 | $19.800 |
| 70-50-011-00 | VALVA B/L ADULTO | $30.600 | $30.600 |
| 70-50-012-00 | VALVA B/L PEDIATRICO | $25.200 | $25.200 |
| 70-50-013-00 | VELPAUX ADULTO | $48.600 | $48.600 |
| 70-50-014-00 | VELPAUX PEDIATRICO | $43.200 | $43.200 |
| 70-50-015-00 | YESO ABP ADULTO | $30.600 | $30.600 |
| 70-50-016-00 | YESO ABP PEDIATRICO | $25.200 | $25.200 |
| 70-50-017-00 | YESO B/P ADULTO | $36.000 | $36.000 |
| 70-50-018-00 | YESO B/P PEDIATRICO | $30.600 | $30.600 |
| 70-50-019-00 | YESO TORACOBRAQUIAL ADULTO | $54.000 | $54.000 |
| 70-50-020-00 | YESO TORACOBRAQUIAL PEDIATRICO | $46.800 | $46.800 |
| Código CHP | Nombre prestación | Valor particular | Valor Fonasa |
|---|---|---|---|
| 27-01-101-00 | EXÁMEN INICIAL, PLAN DE TRATAMIENTO Y PR | $7.500 | $7.500 |
| 27-01-102-00 | CONTROL Y EXÁMEN PERIÓDICO DE RIGOR. | $5.000 | $5.000 |
| 27-01-104-00 | URGENCIA, ACCIÓN MÁS TRATAMIENTO INICIAL | $5.000 | $5.000 |
| 27-01-105-00 | URGENCIA A DOMICILIO, ACCIÓN MÁS TRATAMI | $10.000 | $10.000 |
| 27-01-107-00 | ESTUDIO PRELIMINAR CLÍNICO, RADIOLÓGICO | $10.000 | $10.000 |
| 27-01-109-00 | CONSULTORÍA Y ESTUDIOS PERICIALES, UNA ( | $15.000 | $15.000 |
| 27-01-202-00 | HIGIENE O PROFILAXIS EN NIÑOS. | $5.000 | $5.000 |
| 27-01-203-00 | INSTRUCCIÓN Y CONTROL DE HIGIENE ORAL EN | $5.000 | $5.000 |
| 27-01-204-00 | INSTRUCCIÓN Y CONTROL DE HIGIENE ORAL EN | $5.000 | $5.000 |
| 27-01-205-00 | APLICACIÓN DE FLÚOR EN COLUTORIOS (TRATA | $5.000 | $5.000 |
| 27-01-206-00 | APLICACIÓN DE FLÚOR GEL TOTAL EN NIÑOS O | $10.000 | $10.000 |
| 27-01-207-00 | APLICACIÓN DE FLÚOR SILANO TOTAL EN NIÑO | $25.000 | $25.000 |
| 27-01-208-00 | APLICACIÓN DE SELLANTE FOTOCURADO EN DIE | $5.000 | $5.000 |
| 27-01-209-00 | APLICACIÓN DE SELLANTE FOTOCURADO EN DIE | $7.500 | $7.500 |
| 27-01-210-00 | MANTENEDOR DE ESPACIO FIJO UNILATERAL. | $15.000 | $15.000 |
| 27-01-211-00 | MANTENEDOR DE ESPACIO REMOVIBLE UNILATER | $15.000 | $15.000 |
| 27-01-212-00 | RECEMENTACIÓN DE INCRUSTACIÓN, SIN CORRE | $7.500 | $7.500 |
| 27-01-213-00 | RECEMENTACIÓN DE INCRUSTACIÓN, CON AJUST | $12.500 | $12.500 |
| 27-01-214-00 | RECEMENTACIÓN DE PROTESIS FIJA UNITARIA, | $10.000 | $10.000 |
| 27-01-215-00 | RECEMENTACIÓN DE PROTESIS FIJA UNITARIA, | $15.000 | $15.000 |
| 27-01-216-00 | RECEMENTACIÓN DE PROTESIS FIJA PLURAL, S | $12.500 | $12.500 |
| 27-01-217-00 | RECEMENTACIÓN DE PROTESIS FIJA PLURAL, C | $20.000 | $20.000 |
| 27-01-218-00 | RECUBRIMIENTO PULPAR INDIRECTO, MÁS OBTU | $7.500 | $7.500 |
| 27-01-219-00 | RECUBRIMIENTO PULPAR DIRECTO, MÁS OBTURA | $7.500 | $7.500 |
| 27-01-220-00 | TRATAMIENTO TÓPICO POR HIPERSENSIBILIDAD | $2.500 | $2.500 |
| 27-01-221-00 | OBTURACIÓN CERVICAL SIN CAVIDAD POR HIPE | $7.500 | $7.500 |
| 27-01-222-00 | BLANQUEAMIENTO DE DIENTES DEFINITIVOS, T | $10.000 | $10.000 |
| 27-01-223-00 | BLANQUEAMIENTO DE DIENTES TEMPORALES, OB | $15.000 | $15.000 |
| 27-01-224-00 | ORTODONCIA INTERCEPTIVA, MENTONERA (UN S | $25.000 | $25.000 |
| 27-01-225-00 | MOVER DIENTES EN MORDIDA INVERTIDA A NOR | $10.000 | $10.000 |
| 27-01-301-00 | RADIOGRAFÍA RETROALVEOLAR CUALQUIER TÉCN | $2.000 | $2.000 |
| 27-01-302-00 | RADIOGRAFÍA RETROALVEOLAR TOTAL SUPERIOR | $12.250 | $12.250 |
| 27-01-303-00 | RADIOGRAFÍA ALETA DE MORDIDA (BITE-WING) | $3.000 | $3.000 |
| 27-01-304-00 | RADIOGAFÍA OCLUSAL | $2.500 | $2.500 |
| 27-01-311-00 | RADIOGRAFÍA ARTICULACIÓN TEMPOROMANDIBUL | $10.000 | $10.000 |
| 27-01-312-00 | TELERADIOGRAFÍA. | $10.000 | $10.000 |
| 27-01-313-00 | RADIOGRAFÍA PANORÁMICA. | $10.000 | $10.000 |
| 27-01-314-00 | RADIOGRAFÍAS LATERALES MAXILARES O MANDI | $5.000 | $5.000 |
| 27-01-315-00 | RADIOGRAFIAS DE SENOS MAXILARES | $10.000 | $10.000 |
| 27-01-316-00 | SIALOGRAFÍAS | $10.000 | $10.000 |
| 27-01-317-00 | TOMOGRAFÍAS ARTICULACIÓN TEMPOROMANDIBUL | $10.000 | $10.000 |
| 27-01-318-00 | RADIOGRAFÍA DE MANO. | $5.000 | $5.000 |
| 27-01-319-00 | ANÁLISIS COMPUTARIZADO. | $5.000 | $5.000 |
| 27-01-401-00 | OBTURACIONES SIMPLES. | $7.500 | $7.500 |
| 27-01-402-00 | OBTURACIONES COMPUESTAS. | $12.500 | $12.500 |
| 27-01-403-00 | MUÑONES CON PINES DE RETENCIÓN. | $20.000 | $20.000 |
| 27-01-404-00 | MUÑONES CON PERNOS AL CONDUCTO Y/O PINES | $25.000 | $25.000 |
| 27-01-408-00 | OBTURACIONES CERVICALES CON O SIN CAVIDA | $5.000 | $5.000 |
| 27-01-409-00 | OBTURACIONES DE UNA CARA CON CAVIDAD. | $12.500 | $12.500 |
| 27-01-410-00 | MUÑONES CON PERNOS AL CONDUCTO Y/O PINES | $20.000 | $20.000 |
| 27-01-414-00 | RESTAURACIÓN CERVICAL CON CAVIDAD. | $10.000 | $10.000 |
| 27-01-415-00 | RESTAURACIÓN ANTERIOR SIMPLE CON CAVIDA | $15.000 | $15.000 |
| 27-01-416-00 | RESTAURACIÓN ANTERIOR CON ÁNGULO CON O | $20.000 | $20.000 |
| 27-01-417-00 | RESTAURACIÓN SIMPLE POSTERIOR CON CAVIDA | $17.500 | $17.500 |
| 27-01-418-00 | RESTAURACIÓN COMPUESTA POSTERIOR DOS O M | $22.500 | $22.500 |
| 27-01-419-00 | RECONSTITUCIÓN PARCIAL DE CORONA O CARIL | $22.500 | $22.500 |
| 27-01-420-00 | MUÑONES CON PERNOS AL CONDUCTO Y/O PINES | $25.000 | $25.000 |
| 27-01-421-00 | SELLANTES EN DIENTES DEFINITIVOS. | $7.500 | $7.500 |
| 27-01-425-00 | INLAY SIMPLES O ISOSIT (UNA CARA). | $17.500 | $17.500 |
| 27-01-426-00 | INLAY COMPUESTOS O ISOSIT (DOS CARAS). | $30.000 | $30.000 |
| 27-01-427-00 | ONLAY | $35.000 | $35.000 |
| 27-01-428-00 | CARILLAS CERÁMICAS O RESINA INDIRECTA. | $30.000 | $30.000 |
| 27-01-429-00 | SISTEMA PERNO MUÑÓN COLADO SIMPLE O BIPA | $30.000 | $30.000 |
| 27-01-433-00 | REOBTURACIONES EN DIENTES, ANTES DE UN A | $7.500 | $7.500 |
| 27-01-434-00 | REOBTURACIONES EN DIENTES, ANTES DE DOS | $12.500 | $12.500 |
| 27-01-501-00 | DIAGNÓSTICO CON VITALOMETRÍA. | $7.500 | $7.500 |
| 27-01-502-00 | TREPANACIÓN DE URGENCIA. | $12.500 | $12.500 |
| 27-01-503-00 | PULPOTOMÍA EN DIENTE PERMANENTE VITAL. | $15.000 | $15.000 |
| 27-01-504-00 | INDUCCIÓN AL CIERRE APICAL EN DIENTE NO | $20.000 | $20.000 |
| 27-01-505-00 | VACIAMIENTO DE ABSCESOS. | $15.000 | $15.000 |
| 27-01-506-00 | ENDODONCIA EN INCISIVOS Y CANINOS SIN LE | $30.000 | $30.000 |
| 27-01-507-00 | ENDODONCIA EN PREMOLARES SIN LESIÓN APIC | $35.000 | $35.000 |
| 27-01-508-00 | ENDODONCIA EN MOLARES SIN LESIÓN APICAL. | $50.000 | $50.000 |
| 27-01-509-00 | DESOBTURACIÓN PARCIAL DE CONDUCTO PARA A | $7.500 | $7.500 |
| 27-01-510-00 | RECONSTITUCIÓN PARCIAL DE CORONA PARA AI | $22.500 | $22.500 |
| 27-01-515-00 | ENDODONCIA EN INCISIVOS Y CANINOS CON LE | $32.500 | $32.500 |
| 27-01-516-00 | ENDODONCIA EN PREMOLARES CON LESIÓN APIC | $37.500 | $37.500 |
| 27-01-517-00 | ENDODONCIA EN MOLARES CON LESIÓN APICAL. | $52.500 | $52.500 |
| 27-01-518-00 | BLANQUEAMIENTO DIENTES VITALES. | $15.000 | $15.000 |
| 27-01-519-00 | BLANQUEAMIENTO DIENTES DESVITALIZADOS. | $17.500 | $17.500 |
| 27-01-520-00 | APICEPTOMÍA. | $22.500 | $22.500 |
| 27-01-521-00 | APICEPTOMÍA Y ENDODONCIA SIMULTÁNEA. | $55.000 | $55.000 |
| 27-01-522-00 | APICEPTOMÍA Y OBTURACIÓN A RETRO. | $45.000 | $45.000 |
| 27-01-523-00 | RADECTOMÍA Y/O HEMISECCIÓN DE DIENTE TRA | $20.000 | $20.000 |
| 27-01-524-00 | IMPLANTE ENDODÓNTICO INTRAÓSEO CON O SIN | $50.000 | $50.000 |
| 27-01-525-00 | GINGIVECTOMÍA UNITARIA PARA AISLACIÓN. | $7.500 | $7.500 |
| 27-01-526-00 | RETIRAR ESPIGA METÁLICA DEL CONDUCTO. | $7.500 | $7.500 |
| 27-01-527-00 | FERULIZACIÓN POR GRUPO | $10.000 | $10.000 |
| 27-01-528-00 | TREPANACIÓN DE INCRUSTACIONES Y PRÓTESIS | $7.500 | $7.500 |
| 27-01-529-00 | DESOBTURACIÓN DE CONDUCTOS PARA REPETIR | $7.500 | $7.500 |
| 27-01-601-00 | CONSULTA. | $10.000 | $10.000 |
| 27-01-602-00 | CONTROL Y EXÁMEN PERIÓDICO DE RIGOR. | $7.500 | $7.500 |
| 27-01-604-00 | URGENCIA ODONTOPEDIÁTRICA (UNA SESIÓN). | $10.000 | $10.000 |
| 27-01-608-00 | HIGIENE O PROFILAXIS | $5.000 | $5.000 |
| 27-01-609-00 | DESTARTRAJE SUPRAGINGIVAL Y LIMPIEZA COR | $7.500 | $7.500 |
| 27-01-610-00 | DESTARTRAJE SUBGINGIVAL (POR SESIÓN). | $10.000 | $10.000 |
| 27-01-611-00 | EDUCACIÓN DE HIGIENE BUCAL (POR SESIÓN). | $10.000 | $10.000 |
| 27-01-612-00 | CONTROL DE HIGIENE BUCAL (POR SESIÓN) | $5.000 | $5.000 |
| 27-01-613-00 | APLICACIÓN DE FLÚOR COLUTORIO. | $5.000 | $5.000 |
| 27-01-614-00 | APLICACIÓN DE FLÚOR GEL TOTAL. | $10.000 | $10.000 |
| 27-01-615-00 | APLICACIÓN DE FLÚOR BARNIZ SILANO TOTAL. | $25.000 | $25.000 |
| 27-01-616-00 | SELLANTE DE FOTOCURADO EN DIENTE TEMPORA | $7.500 | $7.500 |
| 27-01-617-00 | SELLANTE DE FOTOCURADO EN DIENTE DEFINIT | $7.500 | $7.500 |
| 27-01-618-00 | MANTENEDOR DE ESPACIO FIJO. | $15.000 | $15.000 |
| 27-01-619-00 | MANTENEDOR DE ESPACIO FIJO CON GUÍA DE E | $20.000 | $20.000 |
| 27-01-620-00 | MANTENEDOR DE ESPACIO REMOVIBLE. | $15.000 | $15.000 |
| 27-01-621-00 | RECEMENTAR INLAY SIN CORRECCIONES. | $7.500 | $7.500 |
| 27-01-622-00 | RECEMENTAR INLAY CON AJUSTE OPERATORIO. | $12.500 | $12.500 |
| 27-01-623-00 | RECEMENTAR CORONA SIN CORRECCIÓN. | $10.000 | $10.000 |
| 27-01-624-00 | RECEMENTAR CORONA CON AJUSTE OPERATORIO. | $15.000 | $15.000 |
| 27-01-625-00 | RECUBRIMIENTO PULPAR INDIRECTO MÁS OBTUR | $7.500 | $7.500 |
| 27-01-626-00 | RECUBRIMIENTO PULPAR DIRECTO MÁS OBTURAC | $10.000 | $10.000 |
| 27-01-627-00 | TRATAMIENTO TÓPICO DE HIPERSENSIBILIDAD | $2.500 | $2.500 |
| 27-01-628-00 | RESINA PREVENTIVA SIMPLE. | $25.000 | $25.000 |
| 27-01-629-00 | RESINA PREVENTIVA COMPUESTA. | $25.000 | $25.000 |
| 27-01-630-00 | ORTODONCIA INTERCEPTIVA. | $25.000 | $25.000 |
| 27-01-631-00 | MOVILIZAR DIENTES DE MORDIDA INVERTIDA A | $10.000 | $10.000 |
| 27-01-632-00 | INMOVILIZACIÓN POR TRAUMATISMO DENTOALVE | $25.000 | $25.000 |
| 27-01-633-00 | FERULIZACIÓN POR TRAUMATISMO DENTOALVEOL | $7.500 | $7.500 |
| 27-01-634-00 | AMALGAMA SIMPLE EN DIENTE TEMPORAL. | $7.500 | $7.500 |
| 27-01-635-00 | AMALGAMA COMPUESTA EN DIENTE TEMPORAL. | $10.000 | $10.000 |
| 27-01-636-00 | AMALGAMA SIMPLE EN DIENTE DEFINITIVO. | $7.500 | $7.500 |
| 27-01-637-00 | AMALGAMA COMPUESTA EN DIENTE DEFINITIVO. | $10.000 | $10.000 |
| 27-01-638-00 | MUÑONES DE AMALGAMA CON PINES DE RETENCI | $20.000 | $20.000 |
| 27-01-639-00 | OBTURACIÓN DE IONÓMERO DE AUTOCURADO CON | $5.000 | $5.000 |
| 27-01-640-00 | OBTURACIÓN DE IONÓMERO UNA CARA CON CAVI | $7.500 | $7.500 |
| 27-01-641-00 | MUÑONES DE COMPOSITE DE FOTOCURADO CON O | $25.000 | $25.000 |
| 27-01-642-00 | MUÑONES DE IONÓMERO DE AUTOCURADO CON O | $20.000 | $20.000 |
| 27-01-643-00 | COMPOSITE SIMPLE EN DIENTES TEMPORALES. | $7.500 | $7.500 |
| 27-01-644-00 | COMPOSITE COMPUESTO EN DIENTES TEMPORALE | $10.000 | $10.000 |
| 27-01-645-00 | COMPOSITE CERVICAL EN DIENTES DEFINITIVO | $10.000 | $10.000 |
| 27-01-646-00 | COMPOSITE ANTERIOR SIMPLE EN DIENTE DEFI | $15.000 | $15.000 |
| 27-01-647-00 | COMPOSITE ANTERIOR COMPUESTO EN DIENTE D | $20.000 | $20.000 |
| 27-01-648-00 | COMPOSITE POSTERIOR SIMPLE EN DIENTE DEF | $17.500 | $17.500 |
| 27-01-649-00 | COMPOSITE POSTERIOR COMPUESTO EN DIENTE | $22.500 | $22.500 |
| 27-01-650-00 | INLAY METÁLICO O ISOSIT EN DIENTE TEMPOR | $15.000 | $15.000 |
| 27-01-651-00 | INLAY METÁLICO O ISOSIT SIMPLE EN DIENTE | $17.500 | $17.500 |
| 27-01-652-00 | INLAY METÁLICO O ISOSIT COMPUESTO EN DIE | $30.000 | $30.000 |
| 27-01-653-00 | ONLAY EN DIENTE DEFINITIVO. | $35.000 | $35.000 |
| 27-01-654-00 | CARILLA DE RESINA INDIRECTA EN DIENTE DE | $30.000 | $30.000 |
| 27-01-655-00 | CORONA PREFORMADA DE ACERO, ACRÍLICO U O | $15.000 | $15.000 |
| 27-01-656-00 | PULPOTOMÍA EN DIENTE TEMPORAL VITAL. | $7.500 | $7.500 |
| 27-01-657-00 | PULPECTOMÍA EN DIENTE TEMPORAL VITAL. | $12.500 | $12.500 |
| 27-01-658-00 | PULPECTOMÍA EN DIENTE DEFINITIVO VITAL. | $25.000 | $25.000 |
| 27-01-659-00 | PULPOTOMÍA O PULPECTOMÍA EN DIENTE TEMPO | $20.000 | $20.000 |
| 27-01-660-00 | PULPOTOMÍA O PULPECTOMÍA EN DIENTE DEFIN | $15.000 | $15.000 |
| 27-01-661-00 | INDUCCIÓN AL CIERRE APICAL EN DIENTE NO | $20.000 | $20.000 |
| 27-01-663-00 | DESGASTE DE INTERFERENCIAS CUSPÍDEAS. | $12.500 | $12.500 |
| 27-01-664-00 | EXÁMEN DE PATOLOGÍA DISFUNCIONAL. | $10.000 | $10.000 |
| 27-01-665-00 | EXODONCIAS SIMPLES DE DIENTES TEMPORALES | $5.000 | $5.000 |
| 27-01-666-00 | EXODONCIAS SIMPLES DE DIENTES DEFINITIVO | $7.500 | $7.500 |
| 27-01-667-00 | EXODONCIAS A COLGAJO DE DIENTES TEMPORAL | $10.000 | $10.000 |
| 27-01-668-00 | FENESTRACIONES DENTARIAS SIMPLES. | $15.000 | $15.000 |
| 27-01-669-00 | VITALOMETRÍA Y DIAGNÓSTICO PULPAR. | $5.000 | $5.000 |
| 27-01-670-00 | DESOBTURACIÓN DE CONDUCTOS PARA RETRATAM | $7.500 | $7.500 |
| 27-01-671-00 | PRÓTESIS REMOVIBLE EN NIÑOS. | $30.000 | $30.000 |
| 27-01-672-00 | TRATAMIENTO EN EL MANEJO DEL NIÑO DIFÍCI | $7.500 | $7.500 |
| 27-01-673-00 | SELLANTE Y OBTURACIÓN CON RESINA EN DIEN | $15.000 | $15.000 |
| 27-01-674-00 | OBTURACIÓN CON CEMENTOS INTERMEDIOS EN D | $5.000 | $5.000 |
| 27-01-675-00 | OBTURACIÓN CON CEMENTOS DE VIDRIO IONÓME | $12.500 | $12.500 |
| 27-01-676-00 | OBTURACIONES SIMPLES CON RESINAS DE AUTO | $10.000 | $10.000 |
| 27-01-677-00 | OBTURACIONES COMPUESTA CON RESINAS DE AU | $12.500 | $12.500 |
| 27-01-678-00 | OBTURACIONES SIMPLES CON RESINAS DE FOTO | $12.500 | $12.500 |
| 27-01-679-00 | OBTURACIONES COMPUESTA CON RESINAS DE FO | $15.000 | $15.000 |
| 27-01-681-00 | INTERCONSULTA ODONTOPEDIATRÍA CON INFORM | $12.500 | $12.500 |
| 27-01-682-00 | PROGRAMA TERAPEÚTICO CON FLÚOR PARA CARI | $25.000 | $25.000 |
| 27-01-683-00 | TRATAMIENTO DE CONDUCTO EN DIENTES TEMPO | $12.500 | $12.500 |
| 27-01-685-00 | RECUBRIMIENTO PULPAR INDIRECTO EN DIENTE | $15.000 | $15.000 |
| 27-01-686-00 | CORONA DE RESINA CON ANCLAJE EN DIENTES | $15.000 | $15.000 |
| 27-01-687-00 | CORONA PREFORMADA METÁLICA EN DIENTES TE | $15.000 | $15.000 |
| 27-01-701-00 | DESTARTRAJE SUPRAGINGIVAL Y PULIDO DE CO | $7.500 | $7.500 |
| 27-01-702-00 | DESTARTRAJE SUBGINGIVAL (POR GRUPO). | $7.500 | $7.500 |
| 27-01-704-00 | TRATAMIENTO DE URGENCIA -GUNA- (POR SESI | $22.500 | $22.500 |
| 27-01-705-00 | PULIDO RADICULAR EN PERIODONTITIS INCIPI | $12.500 | $12.500 |
| 27-01-706-00 | PULIDO RADICULAR EN PERIODONTITIS MODERA | $15.000 | $15.000 |
| 27-01-707-00 | EXÁMEN DE PATOLOGÍA DISFUNCIONAL. | $10.000 | $10.000 |
| 27-01-708-00 | PLANO DE ALIVIO OCLUSAL | $20.000 | $20.000 |
| 27-01-709-00 | CONTROLES POST-TRATAMIENTO | $10.000 | $10.000 |
| 27-01-715-00 | CONSULTA DE ESPECIALIDAD | $10.000 | $10.000 |
| 27-01-717-00 | CONTROLES POST-TRATAMIENTO. | $12.500 | $12.500 |
| 27-01-718-00 | PLANO DE ALIVIO OCLUSAL. | $37.500 | $37.500 |
| 27-01-719-00 | DESGASTE SELECTIVO (POR SESIÓN). | $25.000 | $25.000 |
| 27-01-720-00 | FERULIZACIÓN POR GRUPO | $35.000 | $35.000 |
| 27-01-721-00 | TRATAMIENTO QUÍMICO DEL SACO PERIODONTAL | $20.000 | $20.000 |
| 27-01-722-00 | PULIDO RADICULAR EN PERIODONTITIS INCIPI | $25.000 | $25.000 |
| 27-01-723-00 | PULIDO RADICULAR EN PERIODONTITIS MODERA | $30.000 | $30.000 |
| 27-01-724-00 | GINGIVECTOMÍA (POR GRUPO). | $32.500 | $32.500 |
| 27-01-725-00 | COLGAJO CON PRESERVACIÓN DE PAPILAS (GRU | $40.000 | $40.000 |
| 27-01-727-00 | COLGAJO PERIODONTAL DE ACCESO POR SITIO | $35.000 | $35.000 |
| 27-01-728-00 | CIRUGÍA ÓSEA RESECTIVA POR GRUPO. | $35.000 | $35.000 |
| 27-01-729-00 | INJERTO GINGIVAL LIBRE POR ZONA A INJERT | $45.000 | $45.000 |
| 27-01-730-00 | INJERTO ÓSEO POR GRUPO (NO INCLUYE COLGA | $50.000 | $50.000 |
| 27-01-731-00 | REGENERACIÓN TISULAR GUIADA (RGT), POR S | $50.000 | $50.000 |
| 27-01-732-00 | INJERTO DE TEJIDO CONECTIVO POR GRUPO. | $40.000 | $40.000 |
| 27-01-733-00 | CURETAJE SUBGINGIVAL POR GRUPO. | $35.000 | $35.000 |
| 27-01-734-00 | COBERTURA ACRÍLICA POST-OPERATORIA (NO I | $25.000 | $25.000 |
| 27-01-735-00 | FRENECTOMÍA. | $25.000 | $25.000 |
| 27-01-736-00 | PLASTÍA DE LA ZONA DE FURCACIÓN. | $35.000 | $35.000 |
| 27-01-737-00 | TUNELIZACIÓN EN COMPROMISO DE BIFURCACIÓ | $30.000 | $30.000 |
| 27-01-738-00 | RADECTOMÍA POR DIENTE (NO INCLUYE COLGAJ | $20.000 | $20.000 |
| 27-01-739-00 | ODONTOSECCIÓN POR DIENTE (NO INCLUYE COL | $7.500 | $7.500 |
| 27-01-740-00 | CIRUGÍA MUCOGINGIVAL. | $32.500 | $32.500 |
| 27-01-741-00 | SESIÓN DE MOTIVACIÓN E INSTRUCCIÓN DE HI | $20.000 | $20.000 |
| 27-01-742-00 | ENSEÑANZA Y ADIESTRAMIENTO EN TÉCNICAS D | $17.500 | $17.500 |
| 27-01-743-00 | SESIÓN DE CONTROL DE HIGIENE ORAL (REVEL | $5.000 | $5.000 |
| 27-01-744-00 | CONTROL POST-QUIRÚRGICO Y/O RECAMBIO DE | $10.000 | $10.000 |
| 27-01-801-00 | CORONA PROVISORIA DE ACRÍLICA | $12.500 | $12.500 |
| 27-01-802-00 | CORONA TEMPORAL DE ACRÍLICA O POLICARBOX | $15.000 | $15.000 |
| 27-01-803-00 | PRÓTESIS FIJA PERIFÉRICA COMPLETA METÁLI | $65.000 | $65.000 |
| 27-01-804-00 | PRÓTESIS FIJA PERIFÉRICA PARCIAL METÁLIC | $65.000 | $65.000 |
| 27-01-805-00 | PRÓTESIS FIJA DEFINITIVA EN RESINA ACRÍL | $65.000 | $65.000 |
| 27-01-806-00 | PRÓTESIS FIJA PERIFÉRICA SOBRE CASQUETE | $60.000 | $60.000 |
| 27-01-807-00 | PRÓTESIS FIJA PERIFÉRICA SOBRE SISTEMA E | $60.000 | $60.000 |
| 27-01-808-00 | PRÓTESIS FIJA PERIFÉRICA DE PORCELANA PU | $70.000 | $70.000 |
| 27-01-809-00 | PRÓTESIS FIJA PERIFÉRICA DE PORCELANA SO | $65.000 | $65.000 |
| 27-01-810-00 | GINGIVECTOMÍA UNITARIA. | $7.500 | $7.500 |
| 27-01-811-00 | SISTEMA ESPIGO MUÑÓN METÁLICO. | $30.000 | $30.000 |
| 27-01-812-00 | RETIRO DE ESPIGA DE CONDUCTO. | $7.500 | $7.500 |
| 27-01-813-00 | CONTROLES POST-TRATAMIENTO. | $5.000 | $5.000 |
| 27-01-818-00 | INSERCIÓN DE PRÓTESIS FIJA PLURAL. | $75.000 | $75.000 |
| 27-01-819-00 | INTERMEDIARIO DE PRÓTESIS FIJA PLURAL. | $50.000 | $50.000 |
| 27-01-820-00 | INCRUSTACIÓN METÁLICA COMO INSERCIÓN DE | $40.000 | $40.000 |
| 27-01-821-00 | INSERCIÓN DE PRÓTESIS FIJA PLURAL TIPO M | $35.000 | $35.000 |
| 27-01-822-00 | INTERMEDIARIO DE PRÓTESIS FIJA PLURAL TI | $30.000 | $30.000 |
| 27-01-823-00 | FRENTE ESTÉTICO Ó CARILLA EN PORCELANA O | $40.000 | $40.000 |
| 27-01-824-00 | CONTROLES POS-TRATAMIENTO. | $5.000 | $5.000 |
| 27-01-825-00 | DESOBTURACIÓN PARCIAL DE CONDUCTO PARA A | $7.500 | $7.500 |
| 27-01-826-00 | PROVISORIO SIMPLE PARA PRÓTESIS FIJA PLU | $25.000 | $25.000 |
| 27-01-827-00 | PROVISORIO COMPLEJO PARA PRÓTESIS FIJA P | $35.000 | $35.000 |
| 27-01-828-00 | PROVISORIO DE TRANSICIÓN SIMPLE PARA PRÓ | $75.000 | $75.000 |
| 27-01-829-00 | PROVISORIO DE TRANSICIÓN COMPLEJO PARA P | $100.000 | $100.000 |
| 27-01-901-00 | PRÓTESIS TOTAL SUPERIOR DE ACRÍLICO. | $75.000 | $75.000 |
| 27-01-902-00 | PRÓTESIS TOTAL INFERIOR DE ACRÍLICO. | $87.500 | $87.500 |
| 27-01-903-00 | JUEGO DE PRÓTESIS TOTAL SUPERIOR E INFER | $175.000 | $175.000 |
| 27-01-905-00 | PRÓTESIS INMEDIATA ( NO INCLUYE EXODONCI | $80.000 | $80.000 |
| 27-01-906-00 | REBASADO TOTAL DIRECTO. | $17.500 | $17.500 |
| 27-01-907-00 | REPARACIÓN DE PRÓTESIS CON TOMA DE IMPRE | $15.000 | $15.000 |
| 27-01-908-00 | REPARACIÓN DE PRÓTESIS SIN TOMA DE IMPRE | $10.000 | $10.000 |
| 27-01-909-00 | ARTIFICIOS COMPLEMENTARIOS DE ANCLAJE. | $12.500 | $12.500 |
| 27-01-911-00 | PRÓTESIS DE TRABAJO. | $40.000 | $40.000 |
| 27-01-912-00 | PRÓTESIS COSMÉTICA. | $20.000 | $20.000 |
| 27-01-913-00 | REACONDICIONAMIENTO DE TEJIDOS ( POR SES | $15.000 | $15.000 |
| 27-01-914-00 | CONTROLES POST-TRATAMIENTO. | $7.500 | $7.500 |
| 27-01-915-00 | PRÓTESIS PARCIAL SUPERIOR O INFERIOR DE | $75.000 | $75.000 |
| 27-01-916-00 | PRÓTESIS PARCIAL SUPERIOR O INFERIOR DE | $80.000 | $80.000 |
| 27-01-917-00 | PR´TESIS PARCIAL DE TRANSICIÓN SUPERIOR | $75.000 | $75.000 |
| 27-01-918-00 | REACONDICIONAMIENTO TISULAR PARCIAL. | $25.000 | $25.000 |
| 27-01-919-00 | REACONDICIONAMIENTO TISULAR TOTAL. | $35.000 | $35.000 |
| 27-01-920-00 | REBASADO ACRÍLICO DE BASE PROTÉSICSA. | $30.000 | $30.000 |
| 27-01-921-00 | REBASADO DE BASE PROTÉSICA CON ACRÍLICO | $40.000 | $40.000 |
| 27-02-001-00 | PRIMERA CONSULTA O INTERCONSULTA | $15.000 | $15.000 |
| 27-02-002-00 | EXÁMEN CLÍNICO INICIAL, ESTUDIO DE MODEL | $25.000 | $25.000 |
| 27-02-003-00 | MONTAJE DE CASO EN ARTICULADOR. | $25.000 | $25.000 |
| 27-02-004-00 | CONTROLES ORTODÓNCICOS. | $12.500 | $12.500 |
| 27-02-005-00 | TRATAMIENTO CON APARATOS FIJOS PRESUPUES | $250.000 | $250.000 |
| 27-02-006-00 | TRATAMIENTO CON APARATOS REMOVIBLES PRES | $200.000 | $200.000 |
| 27-02-007-00 | TRATAMIENTO EN ADULTOS PRESUPUESTO POR U | $325.000 | $325.000 |
| 27-02-008-00 | TRATAMIENTO DE CONTENCIÓN PRESUPUESTO PO | $125.000 | $125.000 |
| 27-02-009-00 | APARATOS FIJOS, COSTO MÁXIMO POR ARCADA. | $75.000 | $75.000 |
| 27-02-010-00 | APARATOS REMOVIBLES, COSTO MÁXIMO POR AR | $12.500 | $12.500 |
| 27-02-011-00 | MENTONERA. | $15.000 | $15.000 |
| 27-02-012-00 | ARCO FACIAL. | $15.000 | $15.000 |
| 27-02-013-00 | MÁSCARA DE DELAIRE. | $75.000 | $75.000 |
| 27-02-014-00 | REPOSICIÓN DE BRAQUETS TÉCNICA STANDARD. | $5.000 | $5.000 |
| 27-02-015-00 | BARRA LINGUAL O PALATINA. | $15.000 | $15.000 |
| 27-02-016-00 | QUAD HELIX. | $25.000 | $25.000 |
| 27-02-017-00 | DISYUNCIÓN PALATINA, EXPANSIÓN RÁPIDA. | $35.000 | $35.000 |
| 27-02-018-00 | APARATOS FIJOS, COSTO MÁXIMO POR ARCADA. | $100.000 | $100.000 |
| 27-02-019-00 | FUERZA EXTRAORAL. | $15.000 | $15.000 |
| 27-02-020-00 | ARCO TRANSPALATINO O LINGUAL. | $15.000 | $15.000 |
| 27-02-021-00 | HIGIENIZACIÓN. | $15.000 | $15.000 |
| 27-02-022-00 | CONTENCIÓN RÍGIDA LINGUAL O PALATINA. | $15.000 | $15.000 |
| 27-02-023-00 | CONFECCIÓN Y AJUSTE DE PLANO DEPROGRAMAD | $25.000 | $25.000 |
| 27-02-024-00 | PREDICCIÓN QUIRÚRGICA (ORTOGNÁTICA). | $50.000 | $50.000 |
| 27-02-025-00 | REPOSICIÓN DE BRAQUETS TÉCNICA DE ROTH. | $9.000 | $9.000 |
| 27-02-101-00 | CONSULTA INICIAL CON EXÁMEN MÁXILO-FACIA | $7.500 | $7.500 |
| 27-02-102-00 | INTERCONSULTA DE ESPECIALIDAD CON INFORM | $10.000 | $10.000 |
| 27-02-103-00 | CONTROLES DE LA ESPECIALIDAD. | $5.000 | $5.000 |
| 27-02-104-00 | RECARGO POR ATENCIÓN FUERA DEL LUGAR HAB | $10.000 | $10.000 |
| 27-02-105-00 | EXODONCIA SIMPLE. | $7.500 | $7.500 |
| 27-02-106-00 | EXODONCIA A COLGAJO. | $12.500 | $12.500 |
| 27-02-107-00 | EXODONCIA DE DIENTES INCLUIDOS. | $35.000 | $35.000 |
| 27-02-108-00 | TRATAMIENTO DE ALVEOLORRAGIA, ALVEOLITIS | $10.000 | $10.000 |
| 27-02-109-00 | ALVEOLOPLASTÍA POR HEMIARCADA, NO INCLUY | $25.000 | $25.000 |
| 27-02-110-00 | APICECTOMÍA EN DIENTES ANTERIORES, NO IN | $40.000 | $40.000 |
| 27-02-111-00 | EXÉRESIS DE QUISTE Y/O GRANULOMA PERIAPI | $50.000 | $50.000 |
| 27-02-112-00 | FENESTRACIÓN DENTARIA. | $35.000 | $35.000 |
| 27-02-113-00 | TRATAMIENTO DE COMUNICACIÓN BUCO-SINUSAL | $70.000 | $70.000 |
| 27-02-114-00 | RADECTOMÍA. | $20.000 | $20.000 |
| 27-02-115-00 | APICECTOMÍA EN MOLARES Y PREMOLARES, NO | $65.000 | $65.000 |
| 27-02-116-00 | EXPLORACIÓN QUIRÚRGICA. | $50.000 | $50.000 |
| 27-02-117-00 | GERMECTOMÍA. | $60.000 | $60.000 |
| 27-02-118-00 | BIOPSIA DE MUCOSA. | $17.500 | $17.500 |
| 27-02-120-00 | BIOPSIA INTRAÓSEA. | $40.000 | $40.000 |
| 27-02-121-00 | EXÉRESIS DE GRANDES QUISTES PERIAPICALES | $75.000 | $75.000 |
| 27-02-122-00 | EXÉRESIS DE QUISTES O TUMORES ODONTOGÉNI | $100.000 | $100.000 |
| 27-02-123-00 | EXÉRESIS DE QUISTES O TUMORES ODONTOGÉNI | $200.000 | $200.000 |
| 27-02-124-00 | TRATAMIENTO DE GRANDES QUISTES O TUMORES | $250.000 | $250.000 |
| 27-02-125-00 | EXÉRESIS DE RÁNULA CON SUBLIGÜECTOMÍA. | $135.000 | $135.000 |
| 27-02-126-00 | EXÉRESIS DE MUCOCELE. | $50.000 | $50.000 |
| 27-02-127-00 | EXÉRESIS DE CÁLCULOS SALIVALES. | $100.000 | $100.000 |
| 27-02-128-00 | EXÉRESIS DE GLÁNDULA SUBMAXILAR. | $225.000 | $225.000 |
| 27-02-132-00 | TRATAMIENTO DE ABSCESO SUBMUCOSO DENTOAL | $22.500 | $22.500 |
| 27-02-133-00 | TRATAMIENTO DE ABSCESOS CUTÁNEOS. | $30.000 | $30.000 |
| 27-02-134-00 | TRATAMIENTO DE FLEGMONES O ADENOFLEGMONE | $52.500 | $52.500 |
| 27-02-135-00 | TRATAMIENTO DE FLEGMONES O ADENOFLEGMONE | $100.000 | $100.000 |
| 27-02-139-00 | TRATAMIENTO DE HERIDAS FACIALES CUTÁNEAS | $25.000 | $25.000 |
| 27-02-140-00 | TRATAMIENTO DE HERIDAS FACIALES CUTÁNEAS | $50.000 | $50.000 |
| 27-02-141-00 | TRATAMIENTO DE HERIDAS INTRABUCALES SIMP | $17.500 | $17.500 |
| 27-02-142-00 | TRATAMIENTO DE HERIDAS INTRABUCALES COMP | $35.000 | $35.000 |
| 27-02-143-00 | TRATAMIENTO DE REDUCCIÓN POR LUXACIÓN DE | $25.000 | $25.000 |
| 27-02-144-00 | TRATAMIENTO DE FRACTURA DENTOALVEOLAR (C | $50.000 | $50.000 |
| 27-02-145-00 | TRATAMIENTO ORTOPÉDICO DE FRACTURA DE MA | $75.000 | $75.000 |
| 27-02-146-00 | TRATAMIENTO ORTOPÉDICO DE FRACTURA DE MA | $125.000 | $125.000 |
| 27-02-147-00 | TRATAMIENTO QUIRÚRGICO DE FRACTURA DE MA | $100.000 | $100.000 |
| 27-02-148-00 | TRATAMIENTO QUIRÚRGICO DE FRACTURA DE MA | $150.000 | $150.000 |
| 27-02-149-00 | TRATAMIENTO QUIRÚRGICO DE FRACTURA CIGOM | $75.000 | $75.000 |
| 27-02-150-00 | TRATAMIENTO QUIRÚRGICO DE FRACTURA CIGOM | $125.000 | $125.000 |
| 27-02-151-00 | TRATAMIENTO QUIRÚRGICO DE FRACTURAS FACI | $150.000 | $150.000 |
| 27-02-152-00 | TRATAMIENTO QUIRÚRGICO DE FRACTURAS DEL | $175.000 | $175.000 |
| 27-02-156-00 | RESECCIÓN O PLASTÍA DE FRENILLOS, ETC. | $25.000 | $25.000 |
| 27-02-157-00 | VESTIBULOPLASTÍAS SIMPLES. | $50.000 | $50.000 |
| 27-02-158-00 | RECONSTRUCCIÓN DE REBORDES CON AUTO U HO | $100.000 | $100.000 |
| 27-02-159-00 | REMODELACIÓN QUIRÚRGICA DE REBORDES-PALA | $100.000 | $100.000 |
| 27-02-163-00 | IMPLANTE ENDODÓNTICO (NO INCLUYE VALOR D | $50.000 | $50.000 |
| 27-02-164-00 | IMPLANTE SUBPERIÓSTICO (NO INCLUYE VALOR | $150.000 | $150.000 |
| 27-02-165-00 | IMPLANTE ÓSEOINTEGRADO (NO INCLUYE VALOR | $100.000 | $100.000 |
| 27-02-166-00 | RECONSTRUCCIÓN DE REBORDES CON INJERTOS | $100.000 | $100.000 |
| 27-02-167-00 | ANTROTOMÍA PARA AUMENTO DEL REBORDE ALVE | $100.000 | $100.000 |
| 27-02-168-00 | TRATAMIENTO DE INFECCIÓN PERIIMPLANTARIA | $12.500 | $12.500 |
| 27-02-172-00 | GLOSOPLASTIA | $100.000 | $100.000 |
| 27-02-173-00 | MENTOPLASTÍA | $300.000 | $300.000 |
| 27-02-174-00 | OSTEOTOMÍA SEGMENTARIA DE MAXILA O MANDI | $300.000 | $300.000 |
| 27-02-175-00 | OSTEOTOMÍA MANDIBULAR EN CUERPO. | $250.000 | $250.000 |
| 27-02-176-00 | OSTEOTOMÍA MENDIBULAR EN RAMA | $350.000 | $350.000 |
| 27-02-177-00 | OSTEOTOMÍA TOTAL DE MAXILA (TIPO LE FORT | $425.000 | $425.000 |
| 27-02-178-00 | CIRUGÍA ORTOGNÁTICA COMBINADA DE MAXILA | $600.000 | $600.000 |
| 27-02-182-00 | TRATAMIENTO QUIRÚRGICO DE FISTULA SALIVA | $75.000 | $75.000 |
| 27-02-183-00 | TRATAMIENTO DE FISTULA BUCO-SINUSAL O BU | $100.000 | $100.000 |
| 27-02-184-00 | TRATAMIENTO DE FISURA VELOPALATINA. | $150.000 | $150.000 |
| 27-02-185-00 | SECUESTROMÍA. | $25.000 | $25.000 |
| 27-02-186-00 | ARTROTOMÍA EXPLORATORIA | $50.000 | $50.000 |
| 27-02-187-00 | ATROSCOPÍA. | $100.000 | $100.000 |
| 27-02-188-00 | CIRUGÍA A.T.M. | $250.000 | $250.000 |
| 27-02-189-00 | TRATAMIENTO DE NEURALGIAS - NEUROTOMÍA. | $50.000 | $50.000 |
| 27-02-190-00 | CONSULTA DE LA ESPECIALIDAD. | $14.500 | $14.500 |
| 27-02-191-00 | TOMA DE BIOPSIA DE TEJIDOS BLANDOS. | $36.000 | $36.000 |
| 27-02-192-00 | CITOLOGÍA EXFOLIATIVA. | $7.500 | $7.500 |
| 27-02-193-00 | TEST DE AZUL DE TOLUIDINA. | $7.500 | $7.500 |
| 27-02-194-00 | TOMA DE MUESTRA PARA EXÁMENES MICROBIOLÓ | $7.500 | $7.500 |
| Código CHP | Nombre prestación | Valor particular | Valor Fonasa |
|---|---|---|---|
| 25-01-032-00 | ACCESO VASCULAR COMPLEJO | No disponible | $959.490 |
| 25-01-031-00 | ACCESO VASCULAR SIMPLE | No disponible | $639.670 |
| 25-01-002-00 | APENDICITIS | No disponible | $1.183.770 |
| 25-01-058-00 | BY PASS GASTRICO (PAD) | No disponible | $4.993.380 |
| 25-01-021-00 | CATARATAS (INCLUYE LENTE INTRAOCULAR) | No disponible | $1.121.030 |
| 25-01-001-00 | COLELITIASIS | No disponible | $1.876.680 |
| 25-01-018-00 | CRIPTORQUIDIA | No disponible | $976.820 |
| 25-01-048-00 | DEDOS EN GATILLO | No disponible | $664.980 |
| 25-03-001-00 | DIAG,PREVENCION,OBTURACION UN DIENTE | No disponible | $98.900 |
| 25-01-010-00 | EMBARAZO ECTOPICO | No disponible | $866.690 |
| 25-03-005-00 | ENDODONCIA BIRADICULAR UN DIENTE | No disponible | $167.290 |
| 25-03-006-00 | ENDODONCIA MULTIRADICULAR UN DIENTE | No disponible | $184.200 |
| 25-03-004-00 | ENDODONCIA UNIRADICULAR UN DIENTE | No disponible | $133.420 |
| 25-01-014-00 | ENFERMEDAD CRONICA DE LAS AMIGDALAS | No disponible | $699.320 |
| 25-02-008-00 | ESTUDIO APNEA DEL SUEÑO | No disponible | $377.500 |
| 25-01-017-00 | FIMOSIS | No disponible | $604.430 |
| 25-02-002-00 | HEMORROIDES | No disponible | $825.160 |
| 25-01-005-00 | HERNIA ABDOMINAL COMPLICADA | No disponible | $1.409.910 |
| 25-01-004-00 | HERNIA ABDOMINAL SIMPLE | No disponible | $905.880 |
| 25-01-030-00 | HERNIA DEL NUCLEO PULPOSO (CERVICAL, DOR | No disponible | $2.282.530 |
| 25-01-016-00 | HIPERPLASIA DE LA PROSTATA | No disponible | $1.458.290 |
| 25-01-034-00 | HISTERECTOMIA | No disponible | $1.552.700 |
| 25-01-019-00 | ICTERICIA DEL RECIEN NACIDO | No disponible | $174.230 |
| 25-01-062-00 | INCONTINENCIA URINARIA FEMENINA | No disponible | $2.290.240 |
| 25-01-043-00 | INESTABILIDAD DE HOMBRO | No disponible | $4.199.380 |
| 25-01-047-00 | INESTABILIDAD DE RODILLA | No disponible | $3.707.230 |
| 25-01-036-00 | LITOTRIPSIA EXTRACORPOREA | No disponible | $1.528.920 |
| 25-01-059-00 | MANGA GASTRICA (PAD) | No disponible | $4.667.700 |
| 25-01-035-00 | MENISECTOMIA | No disponible | $1.411.670 |
| 25-03-002-00 | OBTURACION 2 A 4 DIENTES (TRATAMIENTO) | No disponible | $92.830 |
| 25-03-003-00 | OBTURACION 5 Y MAS DIENTES | No disponible | $139.250 |
| 25-01-009-00 | PARTO | No disponible | $1.432.730 |
| 25-01-003-00 | PERITONITIS | No disponible | $1.492.040 |
| 25-01-026-00 | PROLAPSO ANTERIOR O POSTERIOR | No disponible | $1.384.380 |
| 25-01-038-00 | RUPTURA MANGUITO ROTADOR | No disponible | $3.738.470 |
| 25-01-037-00 | SINDROME DEL TUNEL CARPIANO | No disponible | $1.054.110 |
| 25-02-010-00 | TRAT FERTILIZACION BAJA COMPLEJIDAD MUJ | No disponible | $336.730 |
| 25-01-027-00 | TUMORES Y/O QUISTES INTRACRANEANOS | No disponible | $4.367.370 |
| 25-02-003-00 | VARICES | No disponible | $1.150.250 |
| 25-02-004-00 | VARICOCELE | No disponible | $818.510 |
| 25-02-022-00 | VASECTOMIA | No disponible | $853.610 |
| 25-01-015-00 | VEGETACIONES ADENOIDES | No disponible | $600.770 |
| Código CHP | Nombre prestación | Valor particular |
|---|---|---|
| 19-02-055-00 | Adenoma Prostatico reseeccion endoscopica | $4.914.138 |
| 13-02-029-00 | Amigdalectomia | $1.358.490 |
| 12-02-064-00 | Cataratas (no incluye lente) | $2.458.430 |
| 20-04-006-00 | Cesarea | $2.922.240 |
| 12-02-016-00 | Chalazion (unilateral) | $452.290 |
| 19-02-082-00 | Circunsicion | $1.601.168 |
| 18-02-081-00 | Colecistectomia | $3.200.586 |
| 20-03-012-00 | Conizacion | $2.313.225 |
| 21-04-190-00 | Hallux Valgus | No disponible |
| 18-03-18-00 | Hemorroidectomia | $2.039.830 |
| 18-02-153-00 | Hernia sin malla (unilateral) | $2.282.714 |
| 11-03-049-00 | HNP | $4.783.530 |
| 20-03-010-00 | Histerectomia | $3.944.930 |
| 12-02-078-00 | Lasik | No disponible |
| 19-02-090-00 | Litotripsia | $3.865.725 |
| 20-02-002-00 | Mastectomia parcial | $3.292.975 |
| 21-04-159-00 | Menisectomia | $2.490.680 |
| 20-04-003-00 | Parto | $2.586.150 |
| 13-02-052-00 | Rinoplastia | No disponible |
| 17-03-030-00 | Safenectomia Unilateral | $2.192.256 |
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Valores en pesos chilenos. Aranceles vigentes 2026, de carácter referencial.
Clínica Hospital del Profesor - Más salud a tu alcance.
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