| No | Nama Layanan | Tarif | Jenis Pemeriksaan |
|---|---|---|---|
| 1321 | GTT | Rp90.000 | Laboratorium |
| 1322 | Analisa Gas Darah | Rp252.000 | Laboratorium |
| 1323 | CK-MB (massa) | Rp252.000 | Laboratorium |
| 1324 | Glukosa Stick Test | Rp227.000 | Laboratorium |
| 1325 | T4 | Rp200.000 | Laboratorium |
| 1326 | Ferritin | Rp200.000 | Laboratorium |
| 1327 | Besi | Rp91.000 | Laboratorium |
| 1328 | TIBC | Rp139.000 | Laboratorium |
| 1329 | Transferin | Rp156.500 | Laboratorium |
| 1330 | AFP | Rp192.000 | Laboratorium |
