| No | Nama Layanan | Tarif | Jenis Pemeriksaan |
|---|---|---|---|
| 1941 | Eksenterasi | Rp15.200.000 | Prosedur Non Bedah |
| 1942 | Ekstirpasi Tumor Ganas Adnesa + rekonstruksi | Rp15.200.000 | Prosedur Non Bedah |
| 1943 | Enukleasi + DFG | Rp15.200.000 | Prosedur Non Bedah |
| 1944 | Eviserasi + DFG | Rp15.200.000 | Prosedur Non Bedah |
| 1945 | Fraktur Tripodo/Multiple | Rp15.200.000 | Prosedur Non Bedah |
| 1946 | Keratoplasti | Rp15.200.000 | Prosedur Non Bedah |
| 1947 | Koreksi simblefaron berat | Rp15.200.000 | Prosedur Non Bedah |
| 1948 | Operasi Fraktur tripod/Multiple | Rp15.200.000 | Prosedur Non Bedah |
| 1949 | Orbitotomi Lateral | Rp15.200.000 | Prosedur Non Bedah |
| 1950 | Phacoemulsifikasi | Rp15.200.000 | Prosedur Non Bedah |
