健保有給付項目依『全民健康保險醫療費用支付標準』規定收費,未給付項目依本院自費醫療收費標準規定收費
(非健保身分之外國籍病友就醫收費標準,自109年4月1日起依本國籍無健保者再加乘1.3倍計算)
基因醫學部檢驗醫令項目表 |
|||||||
項次 |
醫令碼 |
中文名稱 |
英文名稱 |
價格 |
外加 |
聯絡人 |
單位 |
1 |
000X0102 |
羊膜細胞培養,染色體分析 |
CELL CULTURE&CHROMOSOME ANALYSIS |
6,500 |
- |
彭嬡嫈 71909 |
細胞遺傳 檢驗室 |
2 |
000X0105 |
絨毛膜細胞培養及染色体分析 |
VILLUS CELL CULTURE & CHROMOSOME ANALYSIS |
6,000 |
- |
||
3 |
000X0108 |
絨毛細胞染色體分析 |
CVS for chromosome analysis |
5,500 |
- |
||
4 |
000X0109 |
婦產科家族遺傳檢查 |
OBS/GYN familial genetic exam. |
5,000 |
- |
||
5 |
000X0213 |
血液染色體檢查 |
General chromosome |
5,000 |
- |
||
6 |
000X0159 |
第一代非侵入性產前胎兒染色體檢測 |
Non-invasive prenatal testing |
18,000 |
- |
林孟慧 林齊芳 71916 |
分子遺傳檢驗室 |
7 |
000X0160 |
第二代非侵入性產前胎兒染色體檢測 |
Non-invasive prenatal screening 2 |
30,000 |
- |
||
8 |
000X0161 |
胚胎著床前基因診斷(每個胚胎) |
Preimplantation Genetic Diagnosis,PGD |
6,000 |
- |
||
9 |
000X0162 |
甲型海洋性貧血基因檢測 |
α-thalassemia |
3,500 |
- |
||
10 |
000X0163 |
威爾森氏症基因檢測 |
Wilson's disease |
12,000 |
- |
||
11 |
000X0164 |
小胖威利症及天使症候群基因檢測 |
Prader Willi Syndrome& Angelman Syndrome |
6,000 |
- |
||
12 |
000X0165 |
雷特氏症候群基因檢測 |
Rett Syndrome |
3,100 |
- |
||
13 |
000X0166 |
Miller Dieker症候群LIS1突變點位分析 |
Miller Dieker Syndrome(LIS1mutation analysis) |
5,480 |
- |
||
14 |
000X0167 |
色素失調症基因檢測 |
Incontinentia Pigmenti/ IP,NEMO gene |
9,000 |
- |
||
15 |
000X0168 |
馬凡氏症候群基因檢測 |
Marfan's Syndrome |
9,000 |
- |
||
16 |
000X0169 |
努南氏症基因檢測 |
Noonan Syndrome |
3,060 |
- |
||
17 |
000X0170 |
強直性肌肉失養症基因檢測 |
Myotonic Dystrophy |
4,000 |
- |
||
18 |
000X0171 |
軟骨發育不全症基因檢測 |
Achondroplasia |
7,600 |
- |
||
19 |
000X0172 |
迪喬治症候群基因檢測 |
Di-George Syndrome |
3,260 |
- |
||
20 |
000X0173 |
Miller Dieker症候群LIS1基因缺失分析 |
Miller Dieker Syndrome(LIS1deletion analysis) |
2,940 |
- |
||
21 |
000X0174 |
威廉氏症基因檢測 |
Williams Syndrome |
3,260 |
- |
||
22 |
000X0226 |
染色體晶片分析 |
Array CGH analysis |
18,000 |
- |
||
23 |
000X0016 |
血緣鑑定 |
Paternity Test |
8,000 |
2,000 |
黎淑芳 71914 |
產前遺傳暨親子鑑定檢驗室 |
24 |
000X0201 |
家族遺傳檢查(B) |
Family Genetic Exam (B) |
6,000 |
- |
||
25 |
000X0202 |
手足血緣鑑定 |
SIBLINGSHIP TEST |
13,500 |
- |
||
26 |
000X0203 |
分子基因檢查 |
MOLECULAR GENETIC DIAGNOSIS |
2,000 |
- |
||
27 |
000X0212 |
祖孫血緣鑑定 |
Grandparentage test |
13,500 |
- |
||
28 |
000X0218 |
MSI分子基因檢查 |
Microsatellite instability DNA analysis |
5,000 |
- |
||
29 |
12187C0X |
骨髓移植前基因檢測 |
PreBMT-STR |
4,500 |
- |
||
30 |
12187CYX |
骨髓移植後基因檢測 |
Post-BMT-STR |
4,500 |
- |
||
31 |
12187CZX |
骨髓移植基因檢測 |
Donor-BMT-STR |
4,500 |
- |
||
32 |
000C0422 |
脊髓性肌肉萎縮症(SMA)帶因檢測 |
Spinal Muscular Atrophy (SMA) carrier detection |
2,500 |
- |
翁翊珊 71802/71916 |
產前遺傳暨親子鑑定檢驗室 |
33 |
000X0189 |
進階版非侵入性產前染色體檢驗 |
Non-Invasive Prenatal Test: NIPT Plus |
21,000 |
- |
||
34 |
000X0190 |
雙胞胎進階版非侵入性產前染色體檢驗 |
Non-Invasive Prenatal Test: NIPT Plus (Twin) |
24,000 |
|||
35 |
000X0191 |
胚胎著床前染色體篩檢(PGS)(每個胚胎) |
Pre-implantation Genetic Screening (PGS) |
18,000 |
|||
36 |
000X0192 |
750K單核甘酸基因晶片檢測 |
Cytoscan 750K SNP-base Array |
21,000 |
|||
37 |
000X0200 |
乙型海洋性貧血基因檢測 |
ß-thalassemia |
3,500 |
- |
||
38 |
000X0153 |
嚴重複合型免疫缺乏症新生兒篩檢 |
SCID Newborn Screening |
150 |
- |
胡閔慧 71930 |
新生兒篩檢室 |
39 |
000X0157 |
生物素症新生兒篩檢 |
Neonatal Screening of Biotinidase Disease |
100 |
- |
||
40 |
000X0175 |
腎上腺腦白質失養症(ALD)篩檢 |
Screening for Adrenoleukodystrophy |
240 |
- |
||
41 |
000X0181 |
新生兒篩檢─典型法布瑞氏症, 高雪氏症, 黏多醣症 |
Fabry, Gaucher, MPSs disease screening |
800 |
- |
||
42 |
000X0184 |
新生兒裘馨氏肌肉失養症篩檢 |
Newborn Duchenne Muscular Dystrophy screening |
350 |
- |
||
43 |
000X0185 |
半乳糖濃度 |
Galactose concentration |
150 |
- |
||
44 |
000X0214 |
龐貝氏症篩檢 |
Screening for Pompe Disease |
200 |
- |
||
45 |
000X0176 |
晚發型龐貝氏症篩檢(限1歲以上使用) |
Screening for late-onset Pompe disease (>1 years old ) |
800 |
- |
吳慧璿 71966 |
新生兒篩檢室 |
46 |
000X0177 |
(限男性)法布瑞氏症篩檢(限7歲以上使用) |
(Male) Screening for Fabry disease (>7 years old) |
800 |
- |
||
47 |
000X0178 |
尿中葡萄糖四醣檢驗 |
Urine Glc4 test |
2,000 |
- |
||
48 |
000X0179 |
Lyso-Gb3檢驗 (法布瑞氏症追蹤和帶因者檢查) |
Lyso-Gb3 test (follow-up and carrier of Fabry disease) |
1,200 |
- |
||
49 |
000X0180 |
氧化膽固醇檢驗 (尼曼匹克症排除和追蹤) |
Oxysterol test (R/O and follow-up of Niemann-Pick disease) |
2,000 |
- |
||
50 |
000X0183 |
高雪氏症篩檢(限1歲以上使用) |
Screening for Gaucher disease(>1 years old ) |
800 |
- |
||
51 |
000X0186 |
黏多醣第一型篩檢 |
Screening for MPS I disease (>1 years old) |
900 |
- |
||
52 |
000X0187 |
黏多醣第二型篩檢 |
Screening for MPS II disease (>1 years old) |
900 |
- |
||
53 |
000X0188 |
尿液黏多醣分型檢驗 |
Urinary GAG disaccharides test |
2,000 |
- |
||
54 |
000X0215 |
甲基丙二酸 |
Methylmalonic Acid |
400 |
- |
||
55 |
000X0219 |
琥珀醯丙酮 |
Succinylacetone |
500 |
- |
||
56 |
000X0002 |
小兒代謝遺傳疾病檢查 |
Test for inborn errors of metabolism |
2,000 |
- |
吳慧璿 71966 |
生化遺傳檢驗室 |
57 |
000X0055 |
芳香族L-胺基酸脫羧酵素缺乏症基因分析 |
AADC Deficiency Genetic Assay |
11,500 |
500 |
||
58 |
000X0123 |
基因分析 Level1 |
Genetic Analysis Level 1 |
1,500 |
- |
||
59 |
000X0124 |
基因分析 Level2 |
Genetic Analysis Level 2 |
3,000 |
- |
||
60 |
000X0125 |
基因分析 Level3 |
Genetic Analysis Level 3 |
8,000 |
- |
||
61 |
000X0126 |
基因分析 Level4 |
Genetic Analysis Level 4 |
15,000 |
- |
||
62 |
000X0136 |
脊髓小腦性共濟失調 |
Spinocerebellar Ataxia type Ⅰ,Ⅱ,Ⅲ |
2,000 |
500 |
||
63 |
000X0137 |
齒狀紅核蒼白球萎縮症 |
Dentato-rubro-pallido-luysian atrophy |
1000 |
500 |
||
64 |
000X0138 |
脊髓小腦性共濟失調第17型 |
Spinocerebellar Ataxia type ⅩⅦ |
1,000 |
500 |
||
65 |
000X0139 |
脊髓小腦性共濟失調第6型 |
Spinocerebellar Ataxia type Ⅵ |
1000 |
500 |
||
66 |
000X0140 |
亨丁頓舞蹈症 |
Huntington Disease |
2,000 |
500 |
||
67 |
000X0147 |
甘迺迪氏症基因檢查 |
Kennedy's Disease Genetic Test |
1,000 |
500 |
||
68 |
000X0155 |
粒線體DNA拷貝數目分析 |
MtDNA copy number quantification test |
2,500 |
- |
||
69 |
000X0156 |
粒線體DNA nt3243 A>G定量分析 |
MtDNA nt3243 A>G quantification test |
2,500 |
- |
||
70 |
000X0182 |
TPP1酵素檢查 |
Tripeptidyl peptidase 1 (TPP1) enzyme assay |
5,000 |
- |
||
71 |
000X0206 |
基因分析 Level5 |
Genetic Analysis Level 5 |
20,000 |
- |
||
72 |
000X0207 |
核酸製備 |
DNA Extration |
500 |
- |
||
73 |
000X0239 |
次世代定序粒線體DNA基因變異檢測 |
Next Generation Sequencing for Mitochondrial DNA Variation Test |
15,000 |
- |
||
74 |
000X0254 |
全癌基因檢測 (不含融合基因) |
Comprehensive cancer gene test(without fusion genes) |
58,000 |
- |
||
75 |
000X0256 |
目標基因次世代定序變異判讀-遺傳性疾病基礎分析 |
Targeted NGS variant interpretation – basic genetic disease analysis |
3,000 |
- |
||
76 |
000X0257 |
全外顯子次世代定序變異判讀-遺傳性疾病基礎分析 |
Whole exome NGS variant interpretation – basic genetic disease analysis |
5,000 |
- |
||
77 |
000X0258 |
全基因體次世代定序追加判讀-體藥物基因體學、HLA基因型、及多基因危險性分析 |
Whole genome NGS additional interpretation – pharmacogenomics, HLA, polygenic risk analyses |
15,000 |
- |
||
78 |
000X0262 |
次世代定序全外顯子定序檢測-單基因遺傳疾病 |
Next Generation Sequencing – Whole exome sequencing |
30,000 |
- |
||
79 |
000X0263 |
次世代定序全基因體定序檢測-遺傳疾病 |
Next Generation Sequencing – Whole genome sequencing |
70,000 |
- |
||
80 |
000X0264 |
次世代定序快速一家三口全外顯子檢測-單基因遺傳疾病 |
Next Generation Sequencing – Rapid Trio whole exome sequencing |
116,500 |
- |
||
81 |
000X0265 |
次世代定序肺部疾病套組囊狀纖維化基因變異檢測 |
Next Generation Sequencing - pulmonary disease panel - cystic fibrosis |
15,080 |
- |
||
82 |
000X0266 |
次世代定序威爾森氏症基因變異檢測 |
Next Generation Sequencing - Wilson disease |
7,060 |
- |
||
83 |
12150B0D |
血漿胺基酸定量檢查 |
Plasma Amino Acid Analysis |
2,600 |
- |
||
84 |
12194B00 |
代謝產物串聯質譜儀檢查(陽性追蹤使用) |
Tandem Mass Analysis of Metabolites |
650 |
- |
||
85 |
09089B0D |
尿液有機酸檢查(每次需加CRE-09015C予校正) |
Urine Organic Acid analysis |
2,340 |
- |
||
86 |
000D1113 |
生物素酵素缺乏症全基因分析 |
Biotinidase Deficiency Genetic Assay |
5,500 |
500 |
||
87 |
000X0227 |
次世代定序疾病基因突變檢測—大範圍 |
Next-Generation Sequencing Genetic Test - Large Range (P&P, TAAD, HRD, PFIC, Alagille Syndrome, PLD) |
30,000 |
- |
陳幼玫 范盛之 李昭萱 71910 |
基因分子 診斷實驗室 |
88 |
000X0229 |
次世代定序疾病基因突變檢測-大範圍-結節硬化症 |
NGS genetic test - Large range -Tuberous Sclerosis Complex (TSC) |
30,000 |
- |
||
89 |
000X0233 |
次世代定序疾病基因突變檢測-大範圍-神經退化性疾病 |
NGS genetic test - Large range - Neurodegenerative Diseases (NDD) |
30,000 |
- |
||
90 |
000X0234 |
次世代定序疾病基因突變檢測-大範圍-聽損 |
NGS genetic test - Large range - Deafness (DF) |
30,000 |
- |
||
91 |
000X0236 |
次世代定序疾病基因突變檢測-大範圍-多囊性腎病變 |
NGS genetic test - Large range - Polycystic Kidney Disease (PKD) |
30,000 |
- |
||
92 |
000X0237 |
次世代定序疾病基因突變檢測-大範圍-黃疸 |
NGS genetic test - Large range - Jaundice |
30,000 |
- |
||
93 |
000X0238 |
全新設計已知基因變異單一位點檢測 |
Brand New Designed Genetic Testing For An Untested Variant |
2,840 |
- |
||
94 |
000X0244 |
次世代定序疾病基因突變檢測—中範圍 |
Next-Generation Sequencing Genetic Test - Middle Range (NF, HRD, TD, PMAH,Porphyria) |
15,080 |
- |
||
95 |
000X0245 |
次世代定序疾病基因突變檢測—小範圍 |
Next-Generation Sequencing Genetic Test - Small Range (Deafness, FH, MTC, MEN1, MEN2, PHP, THR, CAH, atypical CAH, cSVD, MH, VHL) |
7,060 |
- |
||
96 |
000X0250 |
次世代定序遺傳性癌症症候群基因檢驗 |
NGS for Hereditary Cancer Syndromes associated Gene Variant Test |
30,000 |
- |
||
97 |
000X0252 |
次世代定序疾病基因突變檢測—中範圍 (癲癇專用) |
Next-Generation Sequencing Genetic Test - Middle Range (for Epilepsy) |
10,000 |
- |
||
98 |
000X0253 |
次世代定序癌症藥物基因檢驗 |
Next-generation sequencing for gene test of cancer medication |
38,500 |
- |
||
99 | 000X0267 |
次世代定序遺傳基因全表現子檢測 (MGD實驗室) 【此檢測由陳沛隆醫師及基因分子診斷室進行分析、判讀以及註解。】 |
NGS genetic test-Germline WES (Lab of MGD) | 30,000 | - | ||
100 | 000X0268 |
次世代定序遺傳基因全基因組檢測 (MGD實驗室) 【此檢測由陳沛隆醫師及基因分子診斷室進行分析、判讀以及註解。】 |
NGS genetic test-Germline WGS (Lab of MGD) | 90,000 | - |