| No | Nama Layanan | Tarif | Jenis Pemeriksaan |
|---|---|---|---|
| 1991 | Masilektomi Partialis | Rp6.600.000 | Prosedur Non Bedah |
| 1992 | Mastektomi Simple | Rp6.600.000 | Prosedur Non Bedah |
| 1993 | Mastektomi Subkutaneus | Rp6.600.000 | Prosedur Non Bedah |
| 1994 | Near Total tiroidektomi | Rp6.600.000 | Prosedur Non Bedah |
| 1995 | Ophorektomi Bilateral | Rp6.600.000 | Prosedur Non Bedah |
| 1996 | Parotidektomi | Rp6.600.000 | Prosedur Non Bedah |
| 1997 | Pembedahan Kompartemental | Rp6.600.000 | Prosedur Non Bedah |
| 1998 | Potong Flap | Rp6.600.000 | Prosedur Non Bedah |
| 1999 | Rekonstruksi sedang (STSG.FTSG.Flap Lokal) | Rp6.600.000 | Prosedur Non Bedah |
| 2000 | Salphingo oophorektomi bilateral | Rp6.600.000 | Prosedur Non Bedah |
