| No | Nama Layanan | Tarif | Jenis Pemeriksaan |
|---|---|---|---|
| 1861 | Tubektomi | Rp5.750.000 | Prosedur Bedah |
| 1862 | Adesolisis | Rp6.700.000 | Prosedur Bedah |
| 1863 | Ekstipasi Adenomiosis | Rp6.700.000 | Prosedur Bedah |
| 1864 | Exflorasi Vagina | Rp6.700.000 | Prosedur Bedah |
| 1865 | Hystrectomy Partial | Rp7.164.000 | Prosedur Bedah |
| 1866 | Hystrectomy Total | Rp6.851.000 | Prosedur Bedah |
| 1867 | Kalporeksis | Rp6.700.000 | Prosedur Bedah |
| 1868 | Kehamilan Ektopik Terganggu (KET) | Rp6.806.000 | Prosedur Bedah |
| 1869 | Kistektomi | Rp7.528.000 | Prosedur Non Bedah |
| 1870 | Laparatomi FC | Rp7.052.000 | Prosedur Non Bedah |