| No | Nama Layanan | Tarif | Jenis Pemeriksaan |
|---|---|---|---|
| 2011 | Mandibulektomi Partialis dengan Rekontruksi | Rp15.200.000 | Prosedur Non Bedah |
| 2012 | Mandibulektomi Totalis | Rp15.200.000 | Prosedur Non Bedah |
| 2013 | Mastektomi Radikal | Rp15.200.000 | Prosedur Non Bedah |
| 2014 | Mastektomi Simpleks | Rp15.200.000 | Prosedur Non Bedah |
| 2015 | Operasi Commando | Rp15.200.000 | Prosedur Non Bedah |
| 2016 | Parotidektomi Radikal + mandibulektomi | Rp15.200.000 | Prosedur Non Bedah |
| 2017 | Pembedahan Forequater | Rp15.200.000 | Prosedur Non Bedah |
| 2018 | Rekosntruksi Mayor | Rp15.200.000 | Prosedur Non Bedah |
| 2019 | Amputasi + Rakonstruksi jari polydactil | Rp2.813.000 | Prosedur Non Bedah |
| 2020 | Amputasi jari extra digit (single) | Rp2.813.000 | Prosedur Non Bedah |
