| No | Nama Layanan | Tarif | Jenis Pemeriksaan |
|---|---|---|---|
| 1601 | USG Pelvis | Rp200.000 | Radiologi |
| 1602 | USG Soft Tissue | Rp250.000 | Radiologi |
| 1603 | USG Scrotum | Rp450.000 | Radiologi |
| 1604 | USG Thorax | Rp360.000 | Radiologi |
| 1605 | USG Thyroid | Rp250.000 | Radiologi |
| 1606 | USG Urologi | Rp203.000 | Radiologi |
| 1607 | USG Whole Abdomen | Rp395.000 | Radiologi |
| 1608 | USG Wrist | Rp150.000 | Radiologi |
| 1609 | USG Wrist Bilateral | Rp200.000 | Radiologi |
| 1610 | CT Abdomen Atas (Dengan Kontras) | Rp2.250.000 | Radiologi |