Tarif Penunjang Medis

RUMAH SAKIT UMUM BINA SEHAT
Jl Raya Dayeuhkolot No 325 Bandung 40257

Telp. (022) 5207963, 5207964, 5207965 Fax. (022) 5207964
e-mail : rsbinasehat@yahoo.co.id
TARIF PENUNJANG MEDIS DI RUMAH SAKIT UMUM BINA SEHAT
TARIF PEMERIKSAAN RADIOLOGI
TARIF
NO JENIS PEMERIKSAAN
KELAS III KELAS II KELAS I VIP
Tanpa Media Kontras
1 Dental 45,000 50,000 55,000 65,000
2 Thorax 70,000 78,000 95,000 110,000
3 Thorax Lateral 120,000 125,000 135,000 150,000
4 Extermitas Atas
a. Shoulder Joint 107,000 118,000 130,000 150,000
b. Humerus 107,000 118,000 130,000 150,000
c. Elbow Joint 107,000 118,000 130,000 150,000
d. Antebrachi 107,000 118,000 130,000 150,000
e. Wrist Joint 107,000 118,000 130,000 150,000
f. Manus 107,000 118,000 130,000 150,000
5 Extermitas Bawah
a. Femur 107,000 118,000 130,000 150,000
b. Genu Joint 107,000 118,000 130,000 150,000
c. Cruris 107,000 118,000 130,000 150,000
d. Anke Joint 107,000 118,000 130,000 150,000
e. Pedis 107,000 118,000 130,000 150,000
6 BNO / Pelvis 85,000 90,00 100,000 120,000
7 Abdoment / BNO 3 Posisi 245,000 265,000 285,000 330,000
8 Schedell AP/LAT 170,000 190,000 210,000 230,000
9 Mandibula 170,000 190,000 210,000 230,000
10 TMJ 170,000 190,000 210,000 230,000
11 SPN 170,000 190,000 210,000 230,000
12 Sella Turcica 170,000 190,000 210,000 230,000
13 Rhese 170,000 190,000 210,000 230,000
14 Schullers 170,000 190,000 210,000 230,000
15 Basis Crani 95,000 105,000 125,000 150,000

Telp. (022) 5207963, 5207964, 5207965 Fax. (022) 5207964
TARIF
Tanpa Media Kontras
16 Towno 95,000 105,000 125,000 150,000
17 Caldwell / Waters 95,000 105,000 125,000 150,000
18 Vertebrae AP/LAT 195,000 210,000 230,000 275,000
19 STL (Soft Tissue Leher) AP+LAT 195,000 210,000 230,000 275,000
20 STN (Soft Tissue Nasal) Lateral 195,000 210,000 230,000 275,000
Dengan Media Kontras

1 Intra Venous Urography 850,000 1,010,000 1,100,000 1,230,000
2 Urethrocystography 850,000 1,010,000 1,100,000 1,230,000
3 Colon In Loop 850,000 1,010,000 1,100,000 1,230,000
4 MD (MAagduodenografi) 850,000 1,010,000 1,100,000 1,230,000
5 OMD (Oesfagusmaagduodenografi) 850,000 1,010,000 1,100,000 1,230,000
6 Fistulography 850,000 1,010,000 1,100,000 1,230,000
Ultrasonography
1 Hepatobillier 160,000 175,000 195,000 260,000
2 Pankreas 160,000 175,000 195,000 260,000
3 Ginjal 160,000 175,000 195,000 260,000
4 Appendix 160,000 175,000 195,000 260,000
5 Uterus 160,000 175,000 195,000 260,000
6 Prostat 160,000 175,000 195,000 260,000
7 Kandungan 215,000 235,000 255,000 275,000
8 Mammae/Payudara 175,000 195,000 220,000 245,000
9 Thyroid 175,000 195,000 220,000 245,000
10 Inguinal 175,000 195,000 220,000 245,000
11 Jaringan Lunak 180,000 197,000 225,000 250,000

Telp. (022) 5207963, 5207964, 5207965 Fax. (022) 5207964
TARIF
Gabungan Organ
1 Abdomen 315,000 330,000 355,000 380,000
2 Upper Abdomen 225,000 245,000 265,000 335,000
3 Lower Abdomen 215,000 235,000 250,000 315,000
*Abdomen Keseluruhan Organ Perut
*Upper Meliputi Organ Hepar, Gallblader, Pankreas, Spleen.
*Lower Meliputi Organ Kedua Ginjal, Vesica Urinaria, Uterus atau Prostat
Keterangan:
1. Untuk Pasien Rawat Jalan dan IGD Berlaku Tarif kelas III
2. Untuk Pasien HCU, Isolasi, Perinatologi tarif sama dengan kelas II
3. Untuk Intra Venous Urography dengan MK Non Ionik Tarif ditambah Rp. 100.000,00
Telp. (022) 5207963, 5207964, 5207965 Fax. (022) 5207964
TARIF PEMERIKSAAN LABORATORIUM
TARIF
Hematologi
a. Hematologi Rutin (Sysmex)
1 Hematologi Lengkap 70,000 70,000 70,000 75,000
2 Trombosit 30,000 30,000 30,000 30,000
3 Hemoglobin 30,000 30,000 30,000 30,000
4 Leukosit 30,000 30,000 30,000 30,000
5 Hematocrit 30,000 30,000 30,000 30,000
6 Eritrosit 30,000 30,000 30,000 30,000
b. Hematologi Rutin (Manual)

1 Golongan Darah 15,000 20,000 28,000 30,000
2 Dif Croont Cell/Hitung Jenis 20,000 25,000 30,000 35,000
3 BSE/LED 30,000 30,000 30,000 35,000
4 Trombosit 25,000 25,000 25,000 25,000
5 Waktu Pembekuan 10,000 15,000 18,000 20,000
6 Waktu Pendarahan 10,000 15,000 18,000 20,000
7 Hemoglobin 25,000 25,000 25,000 25,000
8 Leukosit 25,000 25,000 25,000 25,000
9 Hematocrit 25,000 25,000 25,000 25,000
10 Eritrosit 25,000 25,000 25,000 25,000
11 SADT 175,000 175,000 175,000 175,000
Kimia Darah
1 Gula Darah Sewaktu 23,000 25,000 31,000 33,000
2 Gula Darah Puasa 23,000 25,000 31,000 33,000
3 Gula Darah 2 Jam PP 23,000 25,000 31,000 33,000
4 Bilirubin Total 35,000 35,000 40,000 45,000
5 Bilirubin Direk 35,000 35,000 40,000 45,000

Telp. (022) 5207963, 5207964, 5207965 Fax. (022) 5207964
TARIF
Kimia Darah
6 BIlirubin Indirek 27,000 30,000 35,000 38,000
7 Ureum 28,000 35,000 35,000 38,000
8 Kreatinin 28,000 30,000 35,000 38,000
9 SGOT 28,000 30,000 35,000 38,000
10 SGPT 28,000 30,000 35,000 38,000
11 Albumin 32,000 35,000 37,000 40,000
12 Protein Total 32,000 35,000 37,000 40,000
13 Trigliserida 32,000 35,000 37,000 42,000
14 Cholesterol Total 28,000 30,000 35,000 38,000
15 Uric Acid 28,000 35,000 35,000 38,000
16 Cholesterol HDL 32,000 40,000 37,000 40,000
17 Cholesterol LDL 32,000 35,000 37,000 40,000
18 Elektrolit 200,000 200,000 200,000 200,000
Urine
1 Urine Rutin/Lengkap 28,000 30,000 33,000 35,000
2 Urine Reduksi 12,000 15,000 17,000 20,000
3 PP Test 25,000 25,000 25,000 25,000
Faeces
1 Faeces 32,000 35,000 37,000 40,000
2 IgG, IgM Dengue 275,000 275,000 275,000 275,000
Serologi
1 Widal 500,000 53,000 55,000 60,000
2 Rhematoid Faktor / RE 63,000 70,000 68,000 70,000
3 HbsAg 68,000 70,000 75,000 80,000
Telp. (022) 5207963, 5207964, 5207965 Fax. (022) 5207964

TARIF
Serologi
4 ASTO 63,000 70,000 68,000 70,000
5 CRP 63,000 65,000 68,000 70,000
6 Anti HbsAg 80,000 80,000 80,000 80,000
1 I-CT-TB 110,000 110,000 110,000 110,000

2 Test Narkoba 205,000 205,000 205,000 205,000
Keterangan:
1. Untuk Pasien Rawat Jalan dan IGD Berlaku Tarif kelas II
2. Untuk Pasien HCU, Isolasi, Perinatologi berlaku tarif kelas II
3. Pemeriksaan yang tidak bisa dilakukan di RSU Bina Sejat Dirujuk ke Laboratorium
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RUMAH SAKIT UMUM BINA SEHAT

Jl Raya Dayeuhkolot No 325 Bandung 40257