ICARE EYE HOSPITAL & POST GRADUATE INSTITUTE E-3A, Sector – 26, Noida – 201301 Tel:- 0120-2477600 / 02, Counselor: 0120-2477621 Fax: 0120-2556389 / Appointments: 9811880015 Email: [email protected] / Web: www.icarehospital.org ICARE EYE HOSPITAL RATE LIST 2015 S No. PARTICULAR TARIFF (₹) I CONSULTATION NEW PATIENT VALID FOR 7 DAYS (FIRST TIME CONSULTATION : REGISTRATION + 1 ₹ 600/- CONSULTATION) 2 REVIEW CONSULTATION VALID FOR 7 DAYS ₹ 500/- 3 EMERGENCY CONSULTATION FOR 7 DAYS ₹ 800/- 4 LOW VISUAL AIDS ASSESSMENT CHARGES ₹ 600/- 5 VISION THERAPY CHARGES FOR PER SITTING ₹ 200/- 6 COST OF VISION THERAPY SOFTWARE (CD) ₹ 6,000/- 7 AMBLYOPIA (CD) ₹ 4,000/- II INVESTIGATIONS 1 Digital F.F.A (Fundus Fluoroscein Angiography)(Inclusive of Fundus photo) ₹ 2,500/- 2 Colour Fundus Photo - Digital ₹ 600/- 3 Colour Slit-lamp photo ₹ 600/- 4 Duplicate color prints (FFA/OCT/CLINICAL PHOTO) ₹ 300/- 5 Orthoptic ₹ 250/- 6 OCT (Optical Coherence Tomography) ₹ 2,500/- A Repeat OCT (within 2 months) with printout ₹ 800/- B Anterior Segment OCT ₹ 2,500/- 7 Ultrasonography (U/S) A A Scan – Single Eye ₹ 600/- B B Scan – Single Eye ₹ 1,000/- C UBM - Single Eye ₹ 1,500/- 8 Computerized field analysis A Humphrey Visual Fields (HVF) both eyes ₹ 1,500/- B Humphrey Visual Fields (HVF) One eye ₹ 750/- 9 Diurnal Variation of Tension (Day DVT ) A 5 times tension (Done in both eyes)] ₹ 500/- Page 1 10 Pachymetry (Both eyes) A Ultrasound (Central Corneal Thickness- CST) ₹ 600/- B Optical ₹ 600/- 11 Corneal Topography A Single Eye ₹ 1,000/- B Both Eyes ₹ 2,000/- 12 Orbscan / Pentacam (SHIEMPFLUG Corneal Data Analysis) A Single Eye ₹ 1,000/- B Both Eyes ₹ 2,000/- 13 Specular Microscopy per eye ₹ 1,200/- 14 Electrophysiology A ERG ₹ 3,000/- B EOG ₹ 3,000/- C VEP ₹ 2,500/- D ERG + VEP ₹ 5,500/- E ERG + EOG ₹ 6,000/- F VEP + EOG ₹ 5,500/- G ERG + EOG + VEP ₹ 8,500/- III OPD PROCEDURES 1 Corneal Scrapping and Culture ₹ 500/- + Culture 2 Suture Removal in OPD ₹ 500/- 3 Syringing in OPD ₹ 400/- 4 Sub Conjuctival Injection (Including cost of Syringe) (Cost of Drugs extra) ₹ 300/- 5 Sub Tenons Triamlenolone (Including cost of Syringe) (Cost of Drugs extra) ₹ 500/- 6 Fusion Exercise/ Synaptophore A Full Course (15 days) ₹ 1,500/- B Pleoptic/ Orthoptic PER SITTING ₹ 100/- C Hess chart ₹ 500/- D Diplopia Chart ₹ 250/- 7 Eye Wash (Inclusive all consumables) ₹ 300/- 8 Diplopia Work-up / Recording ₹ 750/- IV INJECTIONS Injection Mannitol with day care admission (Short Stay) Inclusive of cost of 1 ₹ 1,000/- Syringe + Needle + IV Line + Cannula + Medicine) 2 Botox Injection (Per Unit) - In OPD ₹ 300/- 3 Needling with MMC (This package cost is including cost of injection and procedure) ₹ 5,000/- Page 2 Procedure cost for Intravitreal injection (in OT) (Medicine / Injection / Antibiotics 4 ₹ 5,000/- charges extra) Intravitreal Injection Triamanolone Acetonide (IVTA) (Including cost of injection and 5 ₹ 5,000/- procedure) 6 Intravitreal Injection Avastin ₹ 12,000/- 7 Intravitreal Macugen ₹ 60,000/- 8 Intravitreal Lucentis ₹ 25,000/- 9 Intravitreal Insert Ozurdex ₹ 45,000/- V LASERS 1 Cyclocryo/ Cryo / ACR – per sitting/ per eye ₹ 3,000/- 2 Indirect Laser ILO, in OT (Each Eye) ₹ 3,000/- 3 ROP Laser Under TA / GA for Single Eye + GA Charge Extra (single sitting) ₹ 7,000/- 4 ROP Laser Under TA / GA for Both Eye + GA Charge Extra (single sitting) ₹ 9,000/- 5 Yag Laser Iridectomy – Per Eye ₹ 3,000/- 6 Yag Laser Iridectomy – Both Eyes ₹ 5,000/- 7 Yag Laser Capsulotomy– Per Eye ₹ 3,000/- 8 Yag Laser Capsulotomy– Both Eyes ₹ 5,000/- 9 T.T.T – per sitting/ per eye ₹ 3,000/- 10 PAN Retinal Photocoagulation -PRP (single sitting) ₹ 2,500/- 11 Focal Laser - per sitting/ per eye ₹ 3,000/- 12 PDT with Visudyne injection (Inclusive of Drugs) ₹ 86,860/- 13 Laser suturolysis ₹ 2,000/- 14 Gonioplasty ₹ 2,000/- 15 Argon Laser Trabeculoplasty (ALT) ₹ 3,000/- 16 Laser Iridoplasty ₹ 2,000/- VI ROOM AND G.A. CHARGES 1 Room charges A Pvt. Room (per day including Doctor’s visits) ₹ 2,500/- B Semi Pvt. Room (per day including Doctor’s visits) ₹ 1,500/- C Short Stay < 4 Hours > (including Nursuing & Doctor’s Care) ₹ 800/- VII GA CHARGES 1 GA Charges ₹ 6,000/- 2 Short GA without intubation ₹ 2,500/- 3 Anaesthesia Standby / Sedation Charges ₹ 2,000/- 4 Standby Cardiologist during surgery ₹ 3,500/- SHORT PROCEDURES UNDER GA 1 Examination under GA {Including GA charges + PAC (EUA)} ₹ 7,000/- Page 3 2 Probing and Syringing under short GA (Including GA charges + PAC) per eye ₹ 8,000/- OTHER PROCEDURES 1 Neostigmine Test ₹ 2,500/- 2 Tensilon Test ₹ 3,000/- VIII CATARACT & GLAUCOMA SURGERY 1 Trabeculectomy with MMC ₹ 22,000/- 2 Ahmed Glaucoma Valve Glaucoma Drainage device ₹ 35,000/- 3 ECCE/ICCE without IOL ₹ 10,000/- 4 Secondary IOL (AC IOL / PMMA IOL) ₹ 10,000/- 5 Secondary IOL SCLERAL FIXATED IOL (SFIOL) WITH SUTURES ₹ 30,000/- 6 Secondary IOL SCLERAL FIXATED IOL (SFIOL) WITH GLUE ₹ 36,000/- 7 Goniotomy / Trabeculotomy ₹ 20,000/- 8 IOL Repositioning ₹ 5,000/- 9 Trabeculotomy + Trabeculectomy ₹ 25,000/- 10 Anterior chamber wash (AC Wash) ₹ 5,000/- 11 PC Polishing ₹ 5,000/- 12 Needling of Posterior Capsule in OT ₹ 5,000/- 13 Anterior Vitrectomy ₹ 5,000/- Paediatrics cataract surgery (Phaco aspiration + Primary Posterior capsulotomy (PPC) + 14 ₹ 35,000/- Anterior vitrectomy + IOL) ₹ 15,000/- + Cataract 15 TRAB in combined procedure with cataract surgery ( cataract surgery package extra) Surgery Package IX RETINA & POSTERIOR SEGMENT A Scleral Buckling Surgery 1 Scleral Buckle ₹ 25,000/- 2 Scleral Buckle Removal ₹ 7,000/- 3 Belt Buckle (BB) ₹ 3,000/- B Vitreo Retinal Surgery 1 Pars Plana Vitrectomy (PPV- 20 Gauge) ₹ 25,000/- 2 Pars Plana Vitrectomy (PPV- 23 Gauge) - Sutureless ₹ 30,000/- 3 Lensectomy (Lens) - 20 Gauge ₹ 15,000/- 4 Lensectomy (Lens) - 23 Gauge (Sutureless) ₹ 18,000/- 5 Membrane Peeling (MP) ₹ 5,000/- 6 Retinotomy (RR) ₹ 5,000/- 7 Silicon Oil Infusion (SOI) ₹ 5,000/- Page 4 ₹ 15,000/- (Outside patient) & 8 Silicon Oil Removal (SOR) ₹ 10,000/- (For ICARE patient) 9 Endolaser (EL) ₹ 3,000/- 10 SF6 / C3 F8 Gas (5 ml) ₹ 8,000/- 11 Per Fluro Carbon Liquid (PFCL) ₹ 6,000/- 12 IOL Removal (Dislocated Lens removal) ₹ 5,000/- 13 Membranectomy ₹ 6,000/- 14 IOFB Removal ₹ 5,000/- 15 Macular hole surgery ₹ 45,000/- 16 Globe exploration ₹ 5,000/- 17 Core Vitrectomy ₹ 5,000/- 18 Re SOI ₹ 5,000/- 19 Vitreous Lavage ₹ 5,000/- 20 Fluid Gas Exchange (FGE) ₹ 5,000/- 21 AC Tap ₹ 1,500/- X CORNEA 1 EDTA Chelation ₹ 4,000/- 2 Corneal Biopsy Procedure (Cost of biopsy extra) ₹ 2,500/- 3 Tarsorrhaphy ₹ 3,000/- 4 BCL(Bandage Contact Lens) with Glue ₹ 5,000/- 5 EDTA with AMG with BCL ₹ 8,000/- 6 Superficial Keratectomy with AMG with BCL ₹ 8,000/- 7 Suturing of Conjunctival Wound ₹ 5,000/- 8 Suturing of corneal wound ₹ 12,000/- 9 Suturing of scleral wound (Scleral Wound Repair) ₹ 12,000/- 10 Corneal Scleral wound Repair ₹ 15,000/- 11 Pterygium Excision ₹ 6,000/- 12 Pterygium Excision with conjunctival autograft ₹ 14,000/- 13 Pterygium Excision with conjunctival autograft with fibrin Tissue Glue ₹ 20,000/- 14 Amniotic Membrane Grafting ₹ 8,000/- 15 AMG with Fibrin Tissue Glue ₹ 10,000/- 16 Keratoplasty (Penetrating/Lamellar) ₹ 30,000/- 17 Keratoplasty (Penetrating/Lamellar) - FEMTO ASSISTED ₹ 80,000/- 18 Corneal Inlays - (FEMTO ASSISTED) ₹ 90,000/- 19 Therapeutic PK ₹ 15,000/- 20 C3R (BE) ₹ 50,000/- Page 5 21 Anterior Stromal Puncture (Cost of BCL extra) ₹ 4,000/- 22 Keratoplasty with Cataract Surgery (Cost of lens extra) ₹ 35,000/- 23 Scleral Patch Grafts ₹ 15,000/- 24 Limbal Stem Cell Grafting ₹ 15,000/- EXTRA 1 Use of Amniotic Membrane (AMG) (Cost of surgery Extra) ₹ 6,000/- 2 Use of banked Sclera (Cost of surgery Extra) ₹ 4,000/- 3 Use of Fibrin Glue (Cost of surgery Extra) ₹ 8,000/- 4 BCL ₹ 1,000/- 5 Paracentesis ₹ 4,000/- XI REFRACTIVE SURGERY Excimer Laser (Both eyes) 1 I- LASIK (Bladeless - FEMTO LASIK) ₹ 80,000/- 2 Aspheric - LASIK (A - LASIK) ₹ 35,000/- 3 Customvue™ (C - LASIK) ₹ 45,000/- 4 EPI LASIK (E - LASIK) ₹ 45,000/- 5 PTK (per eye) ₹ 12,000/- 6 Implantable Phakic Intra-ocular lens (ICL) per Eye ₹ 60,000/- 7 Implantable Toric (ICL) per Eye ₹ 70,000/- XII SQUINT SURGERY 1 Squint Surgery Horizontal Muscle (Per Muscle) ₹ 8,000/- 2 Squint Surgery Oblique/ Vertical Muscle (Per Muscle) ₹ 10,000/- XIII MISCELLANEOUS 1 AC reformation only (No Suturing) ₹ 5,000/- 2 Resuturing ₹ 4,000/- 3 Iris Prolapse Repair (with resuturing) ₹ 5,000/- 4 Excision Depot Steroid (per eye) ₹ 2,500/- 5 Stitch removal/ Suture removal (SR) – per eye in OT ₹ 1,500/- 6 Removal of foreign body (Deep seated corneal) in OT ₹ 15,000/- 7 Optical Iridectomy ₹ 10,000/- 8 Iris cyst removal (Cost of Biopsy Extra) ₹ 12,000/- XIV OCULOPLASTY 1 Electrolysis Per Eye ₹ 3,500/- 2 Syringing and Probing Per Eye ₹ 3,500/- 3 Artificial eye implantation (per eye) Including cost of artificial/ prosthetic eye ₹ 1,000/- Page 6 4 Tarsorrhaphy ₹ 5,000/- 5 Punctal Snipping Per Eye ₹ 5,000/- 6 Punctoplasty Per Eye ₹ 5,000/- 7 Incision of abscess ₹ 3,500/- 8 Incision of Lacrimal Abscess ₹ 4,000/- 9 Chalazion (per eye) ₹ 3,000/- 10 Wart Excision ₹ 4,000/- 11 Conjunctival suturing ₹ 4,000/- 12 Punctal cautery/ obstruction with suture (per eye) ₹ 2,000/- 13 Entropion Correction / Echopion Correction ₹ 15,000/- 14 Ectropion Correction with Skin Graft ₹ 15,000/- 15 Enucleation ₹ 15,000/- 16 Evisceration ₹ 12,000/- 17 Evisceration with acrylic implant ₹ 16,000/- 18 Evisceration with Hyroxyapatite implant ₹ 16,000/- 19 Enucleation with Hyroxyapatite implant ₹ 18,000/- 20 Extentration ₹ 18,000/- 21 DCT ₹ 15,000/- 22 DCR ₹ 18,000/- 23 DCR with Intubations ₹ 21,000/- 24 Endonasal