| No | Nama Layanan | Tarif | Jenis Pemeriksaan |
|---|---|---|---|
| 2471 | Reseksi Reduksi | Rp9.044.000 | Prosedur Non Bedah |
| 2472 | Sistoplasti Reduksi | Rp9.091.000 | Prosedur Non Bedah |
| 2473 | Spermatocele | Rp6.600.000 | Prosedur Non Bedah |
| 2474 | Torsio Testis | Rp6.600.000 | Prosedur Non Bedah |
| 2475 | TVP/TMP | Rp6.600.000 | Prosedur Non Bedah |
| 2476 | Uretero Sigmoidostomi | Rp8.894.000 | Prosedur Non Bedah |
| 2477 | Uretero Ureterostomi | Rp8.957.000 | Prosedur Non Bedah |
| 2478 | Ureterocutanneostomi | Rp8.956.000 | Prosedur Non Bedah |
| 2479 | Ureterolithotomi | Rp9.039.000 | Prosedur Non Bedah |
| 2480 | Ureterolithotomi Proksimal | Rp6.600.000 | Prosedur Non Bedah |
