| No | Nama Layanan | Tarif | Jenis Pemeriksaan |
|---|---|---|---|
| 1891 | Surgical Staging (Bedah Obgyn) | Rp15.800.000 | Prosedur Non Bedah |
| 1892 | Vulvektomi | Rp15.800.000 | Prosedur Non Bedah |
| 1893 | Eksisi tumor adneksa kecil | Rp2.813.000 | Prosedur Non Bedah |
| 1894 | Foto Koagulasi Laser | Rp2.813.000 | Prosedur Non Bedah |
| 1895 | Gonioplasty | Rp2.813.000 | Prosedur Non Bedah |
| 1896 | Goniotomi (Kecil) | Rp2.813.000 | Prosedur Non Bedah |
| 1897 | Laser iridotomi Perifer | Rp2.813.000 | Prosedur Non Bedah |
| 1898 | Pterigium + CLG | Rp2.813.000 | Prosedur Non Bedah |
| 1899 | Repair ruptur palpebra simpel | Rp2.813.000 | Prosedur Non Bedah |
| 1900 | Reposisi IOL | Rp2.813.000 | Prosedur Non Bedah |
