| No | Nama Layanan | Tarif | Jenis Pemeriksaan |
|---|---|---|---|
| 2341 | Skingrafting Tidak Luas THT | Rp4.375.000 | Prosedur Non Bedah |
| 2342 | Tonsilektomi | Rp5.499.000 | Prosedur Non Bedah |
| 2343 | Tonsilo Adenoidectomi | Rp4.375.000 | Prosedur Non Bedah |
| 2344 | Trakestomi dengan Penyulit | Rp4.375.000 | Prosedur Non Bedah |
| 2345 | Turbinektomi | Rp4.864.000 | Prosedur Non Bedah |
| 2346 | Angiofibroma Nasofaring | Rp6.500.000 | Prosedur Non Bedah |
| 2347 | Bronschoscopy | Rp6.600.000 | Prosedur Non Bedah |
| 2348 | BSEF/FESS 1: Mini | Rp6.600.000 | Prosedur Non Bedah |
| 2349 | BSEF/FESS 2 : Mini+Maksila/etmoid | Rp6.600.000 | Prosedur Non Bedah |
| 2350 | Dekompresia Fasialis | Rp6.600.000 | Prosedur Non Bedah |
