| No | Nama Layanan | Tarif | Jenis Pemeriksaan |
|---|---|---|---|
| 1271 | ICT TB | Rp134.000 | Laboratorium |
| 1272 | HbsAg ELISA otomatik | Rp157.000 | Laboratorium |
| 1273 | TSHS | Rp215.000 | Laboratorium |
| 1274 | FT3 | Rp258.500 | Laboratorium |
| 1275 | FT4 | Rp225.000 | Laboratorium |
| 1276 | CMV IgG | Rp194.000 | Laboratorium |
| 1277 | CMV IgM | Rp194.000 | Laboratorium |
| 1278 | Rubella IgG | Rp250.000 | Laboratorium |
| 1279 | Rubella IgM | Rp188.000 | Laboratorium |
| 1280 | Toxo IgG | Rp203.000 | Laboratorium |
