SNO | Package Name | Category | A1 | A2 | A3 | A4 | A5 | A6 | S1 | S2 |
---|---|---|---|---|---|---|---|---|---|---|
564 | CMU0146 : BRACHYTHERAPY INTRACAVITARY HDR PER APPLICATION | RADIATION ONCOLOGY | 8200 | 8200 | 8200 | 8200 | 8200 | 8200 | 8200 | 8200 |
565 | CMU0147 : PALLIATIVE TREATMENT WITH PHOTONS /ELECTRONS - LINAC | RADIATION ONCOLOGY | 17500 | 17500 | 17500 | 17500 | 17500 | 17500 | 17500 | 17500 |
566 | CMU0148 : RADICAL TREATMENT WITH COBALT 60 EXTERNAL BEAM RT | RADIATION ONCOLOGY | 24800 | 24800 | 24800 | 24800 | 24800 | 24800 | 24800 | 24800 |
567 | CMU0149 : RADICAL TREATMENT WITH PHOTONS / ELECTRONS | RADIATION ONCOLOGY | 44000 | 44000 | 44000 | 44000 | 44000 | 44000 | 44000 | 44000 |
568 | CMU0150 : BRACHYTHERAPY -INTRACAVITARY LDR PER APPLICATION | RADIATION ONCOLOGY | 5000 | 5000 | 5000 | 5000 | 5000 | 5000 | 5000 | 5000 |
569 | CMU0151 : ADJUVANT TREATMENT - CAN BE COMBINED ANY OTHER MODALITY OF TREAMENT - COBALT | RADIATION ONCOLOGY | 20400 | 20400 | 20400 | 20400 | 20400 | 20400 | 20400 | 20400 |
570 | CMU0151-I : NEOADJUVANT TREATMENT - CAN BE COMBINED ANY OTHER MODALITY OF TREAMENT - COBALT | RADIATION ONCOLOGY | 20400 | 20400 | 20400 | 20400 | 20400 | 20400 | 20400 | 20400 |
571 | CMU0152 : ADJUVANT TREATMENT WITH PHOTONS/ELECTRONS | RADIATION ONCOLOGY | 36300 | 36300 | 36300 | 36300 | 36300 | 36300 | 36300 | 36300 |
572 | CMU0152-I : NEOADJUVANT TREATMENT WITH PHOTONS/ELECTRONS | RADIATION ONCOLOGY | 36300 | 36300 | 36300 | 36300 | 36300 | 36300 | 36300 | 36300 |
573 | CMU0153 : BRACHYTHERAPY INTERSTITIAL HDR ONE APPLICATION AND MULTIPLE / SURFACE BRACHYTHERAPY 3TO 5 FRACTIONS / INTRA LUMINAL BRACHYTHERAPY 3 FRACTIONS | RADIATION ONCOLOGY | 20000 | 20000 | 20000 | 20000 | 20000 | 20000 | 20000 | 20000 |
574 | CMU0153 A : SURFACE BRACHYTHERAPY 3TO 5 FRACTIONS | RADIATION ONCOLOGY | 12000 | 12000 | 12000 | 12000 | 12000 | 12000 | 12000 | 12000 |
575 | CMU0153 B : INTRA LUMINAL BRACHYTHERAPY 3 FRACTIONS | RADIATION ONCOLOGY | 7000 | 7000 | 7000 | 7000 | 7000 | 7000 | 7000 | 7000 |
576 | CMU0153 C : BRACHYTHERAPY INTERSTITIAL HDR ONE APPLICATION AND MULTIPLE DOSE FRACTIONS | RADIATION ONCOLOGY | 20000 | 20000 | 20000 | 20000 | 20000 | 20000 | 20000 | 20000 |
577 | CMU0153 D : TNMSC RT- BRACHYTHERAPY INTERSTITIAL HDR ONE APPLICATION AND MULTIPLE DOSE FRACTIONS | RADIATION ONCOLOGY | 45000 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
578 | CMU0154 : PALLIATIVE TREATMENT WITH COBALT 60 EXTERNAL BEAM RT | RADIATION ONCOLOGY | 11700 | 11700 | 11700 | 11700 | 11700 | 11700 | 11700 | 11700 |
579 | CMU0155 : SPECIALIZED RADIATION THERAPY - 3DCRT PACKAGE ADJUVANT (INCLUDES AQUAPLAST MOULD, PLANNINGCT, COUNTOURING, RT PLANNING & EXECUTION) | RADIATION ONCOLOGY | 71400 | 71400 | 71400 | 71400 | 71400 | 71400 | 71400 | 71400 |
580 | CMU0155 A : SPECIALIZED RADIATION THERAPY - 3DCRT PACKAGE ADJUVANT (INCLUDES AQUAPLAST MOULD, PLANNINGCT, COUNTOURING, RT PLANNING & EXECUTION) - TNMSC /GH ONLY | RADIATION ONCOLOGY | 55000 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
581 | CMU0155 A-I : SPECIALIZED RADIATION THERAPY - 3DCRT PACKAGE NEOADJUVANT (INCLUDES AQUAPLAST MOULD, PLANNINGCT, COUNTOURING, RT PLANNING & EXECUTION) - TNMSC /GH ONLY | RADIATION ONCOLOGY | 55000 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
582 | CMU0155-I : SPECIALIZED RADIATION THERAPY - 3DCRT PACKAGE NEOADJUVANT (INCLUDES AQUAPLAST MOULD, PLANNINGCT, COUNTOURING, RT PLANNING & EXECUTION) | RADIATION ONCOLOGY | 71400 | 71400 | 71400 | 71400 | 71400 | 71400 | 71400 | 71400 |
583 | CMU0156 : SSPECIALIZED RADIATION THERAPY 3D CRT- RADICAL (INCLUDES AQUAPLAST MOULD, PLANNINGCT, COUNTOURING, RT PLANNING & EXECUTION) | RADIATION ONCOLOGY | 78800 | 78800 | 78800 | 78800 | 78800 | 78800 | 78800 | 78800 |
584 | CMU0156 A : SPECIALIZED RADIATION THERAPY 3D CRT- RADICAL (INCLUDES AQUAPLAST MOULD, PLANNINGCT, COUNTOURING, RT PLANNING & EXECUTION)- TNMSC/GH ONLY | RADIATION ONCOLOGY | 65000 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
585 | CMU0157 : SPECIALIZED RADIATION THERAPY - IMRT ADJUVANT (INCLUDES AQUAPLAST MOULD, PLANNING CT FOR IMRT, CONTOURING, RT PLANNING, QA, EXECUTION) | RADIATION ONCOLOGY | 93500 | 93500 | 93500 | 93500 | 93500 | 93500 | 93500 | 93500 |
586 | CMU0157 A : SPECIALIZED RADIATION THERAPY - IMRT ADJUVANT (INCLUDES AQUAPLAST MOULD, PLANNING CT FOR IMRT, CONTOURING, RT PLANNING, QA, EXECUTION) - TNMSC/GH ONLY | RADIATION ONCOLOGY | 75000 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
587 | CMU0157 A-I : SPECIALIZED RADIATION THERAPY - IMRT NEOADJUVANT (INCLUDES AQUAPLAST MOULD, PLANNING CT FOR IMRT, CONTOURING, RT PLANNING, QA, EXECUTION) - TNMSC/GH ONLY | RADIATION ONCOLOGY | 75000 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
588 | CMU0157-I : SPECIALIZED RADIATION THERAPY - IMRT NEOADJUVANT (INCLUDES AQUAPLAST MOULD, PLANNING CT FOR IMRT, CONTOURING, RT PLANNING, QA, EXECUTION) | RADIATION ONCOLOGY | 93500 | 93500 | 93500 | 93500 | 93500 | 93500 | 93500 | 93500 |
589 | CMU0158 : SPECIALIZED RADIATION THERAPY - IMRT - RADICAL (INCLUDES AQUAPLAST MOULD, PLANNINGCT, COUNTOURING, RT PLANNING & EXECUTION) 34-40 FRACTIONS | RADIATION ONCOLOGY | 105000 | 105000 | 105000 | 105000 | 105000 | 105000 | 105000 | 105000 |
590 | CMU0158 A : SPECIALIZED RADIATION THERAPY - IMRT - RADICAL (INCLUDES AQUAPLAST MOULD, PLANNINGCT, COUNTOURING, RT PLANNING & EXECUTION) - TNMSC /GH ONLY | RADIATION ONCOLOGY | 90000 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
591 | CMU0159 : SPECIALIZED RADIATION THERAPY - IMRT WITH IGRT (INCLUDES AQUAPLAST MOULD, PLANNINGCT, COUNTOURING, RT PLANNING & EXECUTION) | RADIATION ONCOLOGY | 157500 | 157500 | 157500 | 157500 | 157500 | 157500 | 157500 | 157500 |
592 | CMU0159 A : SPECIALIZED RADIATION THERAPY - IMRT WITH IGRT (INCLUDES AQUAPLAST MOULD, PLANNINGCT, COUNTOURING, RT PLANNING & EXECUTION) - TNMSC /GH ONLY | RADIATION ONCOLOGY | 110000 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
593 | CMU0160 : SPECIALIZED RADIATION THERAPY - RAPID ARC THERAPY (INCLUDES AQUAPLAST MOULD, PLANNINGCT, COUNTOURING, RT PLANNING & EXECUTION) | RADIATION ONCOLOGY | 157500 | 157500 | 157500 | 157500 | 157500 | 157500 | 157500 | 157500 |
594 | CMU0160 A : SPECIALIZED RADIATION THERAPY - RAPID ARC THERAPY (INCLUDES AQUAPLAST MOULD, PLANNINGCT, COUNTOURING, RT PLANNING & EXECUTION) - TNMSC /GH ONLY | RADIATION ONCOLOGY | 110000 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
595 | CMU0161 : BRACHYTHERAPY INTERSTITIAL LDR PER APPLICATION | RADIATION ONCOLOGY | 15000 | 15000 | 15000 | 15000 | 15000 | 15000 | 15000 | 15000 |
596 | CMU0162 : TOTAL BODY RADIATION | RADIATION ONCOLOGY | 44000 | 44000 | 44000 | 44000 | 44000 | 44000 | 44000 | 44000 |
597 | CMU0163 : SPECIALIZED RADIATION THERAPY - SRS/SRT/SBRT (INCLUDES AQUAPLAST MOULD, PLANNINGCT, COUNTOURING, RT PLANNING & EXECUTION) | RADIATION ONCOLOGY | 87500 | 87500 | 87500 | 87500 | 87500 | 87500 | 87500 | 87500 |
598 | CMU0163A : SPECIALIZED RADIATION THERAPY - SRS/SRT/SBRT (INCLUDES AQUAPLAST MOULD, PLANNINGCT, COUNTOURING, RT PLANNING & EXECUTION) | RADIATION ONCOLOGY | 87500 | 87500 | 87500 | 87500 | 87500 | 87500 | 87500 | 87500 |
599 | CMU0163B : SPECIALIZED RADIATION THERAPY - SRS/SRT/SBRT (INCLUDES AQUAPLAST MOULD, PLANNINGCT, COUNTOURING, RT PLANNING & EXECUTION) | RADIATION ONCOLOGY | 87500 | 87500 | 87500 | 87500 | 87500 | 87500 | 87500 | 87500 |
600 | CMU0164 : CRANIOSPINAL RADIATION | RADIATION ONCOLOGY | 150000 | 150000 | 150000 | 150000 | 150000 | 150000 | 150000 | 150000 |
601 | CMU0165 : HEMOSTATIC RT - LINAC BASED | RADIATION ONCOLOGY | 15000 | 15000 | 15000 | 15000 | 15000 | 15000 | 15000 | 15000 |
3643 | CMU1395A : Linear Accelerator External Beam Radiotherapy IGRT (Image Guided radiotherapy) with 3D CRT) - 35 Fractions | RADIATION ONCOLOGY | 146000 | 146000 | 146000 | 146000 | 146000 | 146000 | 146000 | 146000 |
3644 | CMU1395B : Linear Accelerator External Beam Radiotherapy IGRT (Image Guided radiotherapy) with 3D CRT (20 Fractions) (Inclusive of Simulation & Planning Cost) - Adjuvant | RADIATION ONCOLOGY | 134000 | 134000 | 134000 | 134000 | 134000 | 134000 | 134000 | 134000 |
3645 | CMU1395C : Linear Accelerator External Beam Radiotherapy IGRT (Image Guided radiotherapy) with 3D CRT (20 Fractions) (Inclusive of Simulation & Planning Cost) - Neoadjuvant | RADIATION ONCOLOGY | 134000 | 134000 | 134000 | 134000 | 134000 | 134000 | 134000 | 134000 |
3646 | CMU1396A : Linear Accelerator External Beam Radiotherapy IGRT (Image Guided radiotherapy) with 3D CRT) (Inclusive of Simulation & Planning Cost) | RADIATION ONCOLOGY | 97000 | 97000 | 97000 | 97000 | 97000 | 97000 | 97000 | 97000 |
3647 | CMU1396B : Linear Accelerator External Beam Radiotherapy IGRT (Image Guided radiotherapy) with 3D CRT (Inclusive of Simulation & Planning Cost) - Adjuvant | RADIATION ONCOLOGY | 84500 | 84500 | 84500 | 84500 | 84500 | 84500 | 84500 | 84500 |
3648 | CMU1396C : Linear Accelerator External Beam Radiotherapy IGRT (Image Guided radiotherapy) with 3D CRT (Inclusive of Simulation & Planning Cost) - Neoadjuvant | RADIATION ONCOLOGY | 84500 | 84500 | 84500 | 84500 | 84500 | 84500 | 84500 | 84500 |
3649 | CMU1397A : SRT / SBRT with IGRT (Stereotacatic radiotherapy) (8 Fractions) (Inclusive of Simulation & Planning Cost) | RADIATION ONCOLOGY | 106600 | 106600 | 106600 | 106600 | 106600 | 106600 | 106600 | 106600 |
3650 | CMU1398A : SRS with IGRT (Stereotacatic radiotherapy) (Inclusive of Simulation & Planning Cost) | RADIATION ONCOLOGY | 91000 | 91000 | 91000 | 91000 | 91000 | 91000 | 91000 | 91000 |
3651 | CMU1399A : Respiratory Gating as addon | RADIATION ONCOLOGY | 81300 | 81300 | 81300 | 81300 | 81300 | 81300 | 81300 | 81300 |
3652 | CMU1400C : Brachytherapy High Dose Radiation (2D/X-ray) (Maximum of 4 session) - Endobiliary | RADIATION ONCOLOGY | 3900 | 3900 | 3900 | 3900 | 3900 | 3900 | 3900 | 3900 |
3653 | CMU1400D : Brachytherapy High Dose Radiation (2D/X-ray) (Maximum of 4 session) - Endobronchial | RADIATION ONCOLOGY | 3900 | 3900 | 3900 | 3900 | 3900 | 3900 | 3900 | 3900 |
3654 | CMU1400E : Brachytherapy High Dose Radiation (2D/X-ray) (Maximum of 4 session) - CVS | RADIATION ONCOLOGY | 3900 | 3900 | 3900 | 3900 | 3900 | 3900 | 3900 | 3900 |
3655 | CMU1401A : iodine treatment 3 mCi - large Dose scan/ Pre Ablation - calculation of treatment | RADIATION ONCOLOGY | 11400 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
3656 | CMU1401B : iodine treatment 30 mCi - Ablation of residual disease - any risk | RADIATION ONCOLOGY | 16900 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
3657 | CMU1402A : Iodine treatment 50 mCi - Ablation of residual neck disease - low / intermediate risk | RADIATION ONCOLOGY | 18000 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
3658 | CMU1403A : Iodine treatment 100 mCi - Ablation for metastatic disease - High risk | RADIATION ONCOLOGY | 22400 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
3659 | CMU1404A : Iodine treatment 150 mCi - Ablation for metastatic disease - High risk | RADIATION ONCOLOGY | 30100 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
3660 | CMU1405A : Iodine treatment 200 mCi - Ablation for metastatic disease - High risk | RADIATION ONCOLOGY | 34500 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
3661 | CMU1406A : Iodine treatment 250 mCi - Ablation for metastatic disease - High risk | RADIATION ONCOLOGY | 40000 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
4262 | CMU1813-I : RADIATION THERAPY FOR INTRACRANIAL / SPINAL BENIGN DISEASE - LINAC BASED 3DCRT PACKAGE ADJUVANT (INCLUDES AQUAPLAST MOULD, PLANNINGCT, COUNTOURING, RT PLANNING & EXECUTION) | RADIATION ONCOLOGY | 157500 | 157500 | 157500 | 157500 | 157500 | 157500 | 157500 | 157500 |
4263 | CMU1813-IA : RADIATION THERAPY FOR INTRACRANIAL / SPINAL BENIGN DISEASE - LINAC BASED 3DCRT PACKAGE ADJUVANT (INCLUDES AQUAPLAST MOULD, PLANNINGCT, COUNTOURING, RT PLANNING & EXECUTION) - TNMSC /GH ONLY | RADIATION ONCOLOGY | 157500 | 157500 | 157500 | 157500 | 157500 | 157500 | 157500 | 157500 |
4264 | CMU1813-II : RADIATION THERAPY FOR INTRACRANIAL / SPINAL BENIGN DISEASE - LINAC BASED 3D CRT- RADICAL (INCLUDES AQUAPLAST MOULD, PLANNINGCT, COUNTOURING, RT PLANNING & EXECUTION) | RADIATION ONCOLOGY | 157500 | 157500 | 157500 | 157500 | 157500 | 157500 | 157500 | 157500 |
4265 | CMU1813-IIA : RADIATION THERAPY FOR INTRACRANIAL / SPINAL BENIGN DISEASE - LINAC BASED 3D CRT- RADICAL (INCLUDES AQUAPLAST MOULD, PLANNINGCT, COUNTOURING, RT PLANNING & EXECUTION)- TNMSC/GH ONLY | RADIATION ONCOLOGY | 157500 | 157500 | 157500 | 157500 | 157500 | 157500 | 157500 | 157500 |
4266 | CMU1813-III : RADIATION THERAPY FOR INTRACRANIAL / SPINAL BENIGN DISEASE - LINAC BASED IMRT ADJUVANT (INCLUDES AQUAPLAST MOULD, PLANNING CT FOR IMRT, CONTOURING, RT PLANNING, QA, EXECUTION) | RADIATION ONCOLOGY | 157500 | 157500 | 157500 | 157500 | 157500 | 157500 | 157500 | 157500 |
4267 | CMU1813-IIIA : RADIATION THERAPY FOR INTRACRANIAL / SPINAL BENIGN DISEASE - LINAC BASED IMRT ADJUVANT (INCLUDES AQUAPLAST MOULD, PLANNING CT FOR IMRT, CONTOURING, RT PLANNING, QA, EXECUTION) - TNMSC/GH ONLY | RADIATION ONCOLOGY | 157500 | 157500 | 157500 | 157500 | 157500 | 157500 | 157500 | 157500 |
4268 | CMU1813-IV : RADIATION THERAPY FOR INTRACRANIAL / SPINAL BENIGN DISEASE - LINAC BASED IMRT - RADICAL (INCLUDES AQUAPLAST MOULD, PLANNINGCT, COUNTOURING, RT PLANNING & EXECUTION) | RADIATION ONCOLOGY | 157500 | 157500 | 157500 | 157500 | 157500 | 157500 | 157500 | 157500 |
4269 | CMU1813-IVA : RADIATION THERAPY FOR INTRACRANIAL / SPINAL BENIGN DISEASE - LINAC BASED IMRT - RADICAL (INCLUDES AQUAPLAST MOULD, PLANNINGCT, COUNTOURING, RT PLANNING & EXECUTION) - TNMSC /GH ONLY | RADIATION ONCOLOGY | 157500 | 157500 | 157500 | 157500 | 157500 | 157500 | 157500 | 157500 |
4270 | CMU1813-V : RADIATION THERAPY FOR INTRACRANIAL / SPINAL BENIGN DISEASE - LINAC BASED IMRT WITH IGRT (INCLUDES AQUAPLAST MOULD, PLANNINGCT, COUNTOURING, RT PLANNING & EXECUTION) | RADIATION ONCOLOGY | 157500 | 157500 | 157500 | 157500 | 157500 | 157500 | 157500 | 157500 |
4271 | CMU1813-VA : RADIATION THERAPY FOR INTRACRANIAL / SPINAL BENIGN DISEASE - LINAC BASED IMRT WITH IGRT (INCLUDES AQUAPLAST MOULD, PLANNINGCT, COUNTOURING, RT PLANNING & EXECUTION) - TNMSC /GH ONLY | RADIATION ONCOLOGY | 157500 | 157500 | 157500 | 157500 | 157500 | 157500 | 157500 | 157500 |
4272 | CMU1813-VI : RADIATION THERAPY FOR INTRACRANIAL / SPINAL BENIGN DISEASE - LINAC BASED RAPID ARC THERAPY (INCLUDES AQUAPLAST MOULD, PLANNINGCT, COUNTOURING, RT PLANNING & EXECUTION) | RADIATION ONCOLOGY | 157500 | 157500 | 157500 | 157500 | 157500 | 157500 | 157500 | 157500 |
4273 | CMU1813-VIA : RADIATION THERAPY FOR INTRACRANIAL / SPINAL BENIGN DISEASE - LINAC BASED RAPID ARC THERAPY (INCLUDES AQUAPLAST MOULD, PLANNINGCT, COUNTOURING, RT PLANNING & EXECUTION) - TNMSC /GH ONLY | RADIATION ONCOLOGY | 157500 | 157500 | 157500 | 157500 | 157500 | 157500 | 157500 | 157500 |