| No | Nama Layanan | Tarif | Jenis Pemeriksaan |
|---|---|---|---|
| 2401 | Septorinoplasty THT | Rp15.200.000 | Prosedur Non Bedah |
| 2402 | Stapedektomi | Rp15.200.000 | Prosedur Non Bedah |
| 2403 | Temporal Bone Resection | Rp15.200.000 | Prosedur Non Bedah |
| 2404 | Timpano Plastik | Rp15.200.000 | Prosedur Non Bedah |
| 2405 | Tindakan Dekompresi Fasialis | Rp15.200.000 | Prosedur Non Bedah |
| 2406 | Cabut DJ Stent | Rp2.813.000 | Prosedur Non Bedah |
| 2407 | Vasektomi dengan Narkose | Rp2.903.000 | Prosedur Non Bedah |
| 2408 | Biopsi Ginjal Perkutan | Rp4.350.000 | Prosedur Non Bedah |
| 2409 | Biopsi Prostat | Rp4.146.000 | Prosedur Non Bedah |
| 2410 | Biopsi Testis | Rp4.340.000 | Prosedur Non Bedah |
