| No | Nama Layanan | Tarif | Jenis Pemeriksaan |
|---|---|---|---|
| 1121 | Cold Pack | Rp55.500 | Rehabilitasi |
| 1122 | Nebulizer (Rawat Jalan) | Rp140.000 | Penunjang |
| 1123 | Assesmen FT | Rp60.000 | Rehabilitasi |
| 1124 | Latihan Ketahanan Kardiopulmonal (Ergocycle) | Rp67.500 | Rehabilitasi |
| 1125 | CPM Set | Rp67.500 | Rehabilitasi |
| 1126 | Magneto Therapy | Rp72.000 | Rehabilitasi |
| 1127 | Cryotherapy | Rp67.500 | Rehabilitasi |
| 1128 | Pool Therapy | Rp67.500 | Rehabilitasi |
| 1129 | Latihan Sedang | Rp60.000 | Rehabilitasi |
| 1130 | Latihan Pernafasan | Rp63.000 | Rehabilitasi |