| No | Nama Layanan | Tarif | Jenis Pemeriksaan |
|---|---|---|---|
| 2441 | Johanson | Rp6.600.000 | Prosedur Non Bedah |
| 2442 | Johanson I | Rp6.600.000 | Prosedur Non Bedah |
| 2443 | Koreksi Priapismus | Rp6.600.000 | Prosedur Non Bedah |
| 2444 | Laparatomi Eksplorasi (Besar. Bedah Digestif) | Rp6.542.000 | Prosedur Bedah |
| 2445 | Litrotipasi / litotripsi | Rp7.088.000 | Prosedur Non Bedah |
| 2446 | MMK/ Sling Uretra | Rp6.600.000 | Prosedur Non Bedah |
| 2447 | Nefropeksi/Renopeksi | Rp6.600.000 | Prosedur Non Bedah |
| 2448 | Nefropexie | Rp7.898.000 | Prosedur Non Bedah |
| 2449 | Nefrostomi | Rp7.898.000 | Prosedur Non Bedah |
| 2450 | Nefrostomi Terbuka/ Permanen | Rp6.600.000 | Prosedur Non Bedah |
