Daftar Harga Radiologi

No NAMA Rwt Jalan UGD CLASS I CLASS II CLASS III

1 Abdomen 2 Posisi 308,000 308,000 372,680 338,800 308,000
2 Abdomen 3 Posisi 352,000 352,000 425,920 387,200 352,000
3 Abdomen Polos (BNO) 148,500 148,500 179,685 163,350 148,500
4 Ankle Joint Ka & Ka 308,000 308,000 372,680 338,800 308,000
5 Ankle Joint Ka/Ki 181,500 181,500 219,615 199,650 181,500
6 Antebrachi Ka & Ki 308,000 308,000 372,680 338,800 308,000
7 Antebrachi Ka / Ki 181,500 181,500 219,615 199,650 181,500
8 Appendicogram 440,000 440,000 532,400 484,000 440,000
9 Art. Bahu Ka & Ki 308,000 308,000 372,680 338,800 308,000
10 Art. Bahu Ki / Ka 181,500 181,500 219,615 199,650 181,500
11 Art. Genu Ka & Ki 308,000 308,000 372,680 338,800 308,000
12 Art. Genu Ki / Ka 181,500 181,500 219,615 199,650 181,500
13 Baby Gram 187,000 187,000 226,270 205,700 187,000
14 BNO & IVP 1,375,000 1,375,000 1,663,750 1,512,500 1,375,000
15 Bone Survey 2,200,000 2,200,000 2,662,000 2,420,000 2,200,000
16 CD/FILM RONTGEN PER LEMBAR 82,500 82,500 99,825 90,750 82,500
17 Cell. Vert. Thoracalis 2 Posisi 203,500 203,500 246,235 223,850 203,500
18 CEPHALOMETRI 192,500 192,500 232,925 211,750 192,500
19 Cervicothoracal 2 Posisi 289,300 289,300 350,053 318,230 289,300
20 Cholangiografi 501,600 501,600 606,936 551,760 501,600
21 Cholesystografi 501,600 501,600 606,936 551,760 501,600
22 Clavikula Ka & Ki 297,000 297,000 359,370 326,700 297,000
23 Clavikula Ka / Ki 181,500 181,500 219,615 199,650 181,500
24 Coll. Vert. Cervikalis 2 Posisi 181,500 181,500 219,615 199,650 181,500
25 Coll. Vert. Cervikalis 4 Posisi 275,000 275,000 332,750 302,500 275,000
26 Coll. Vert. Lumbalis 2 Posisi 202,070 202,070 244,505 222,277 202,070
27 Coll. Vert. Lumbalis 4 Posisi 319,000 319,000 385,990 350,900 319,000
28 Coll. Vert. Thoracalis 2 Posisi 202,070 202,070 244,505 222,277 202,070
29 Coll. Vert. Thoracalis 4 Posisi 319,000 319,000 385,990 350,900 319,000
30 Colon in Loop ( R ) 1,849,100 1,849,100 2,237,411 2,034,010 1,849,100
31 colon in loop + anastesi 3,533,750 3,533,750 4,275,838 3,887,125 3,533,750
32 COR Analse 212,300 212,300 256,883 233,530 212,300
33 Cranium 181,500 181,500 219,615 199,650 181,500
34 Cruris Ka & Ki 308,000 308,000 372,680 338,800 308,000
35 Cruris Ka / Ki 181,500 181,500 219,615 199,650 181,500
36 CT-SCAN Abdomen 3 Dimensi 4,158,000 4,158,000 5,031,180 4,573,800 4,158,000
37 CT-SCAN Abdomen Dengan Kontra 3,780,000 3,780,000 3,780,000 3,780,000 3,780,000
38 CT-SCAN Angiography (Head, Neck 3,168,000 3,168,000 3,833,280 3,484,800 3,168,000
39 CT-SCAN Cervical 3 Dimensi 3,168,000 3,168,000 3,833,280 3,484,800 3,168,000
40 CT-SCAN Cervical Spine Dengan Ko1,680,000 1,680,000 2,032,800 1,848,000 1,680,000
41 CT-SCAN Cervical Spine Tanpa Kon 1,050,000 1,050,000 1,270,500 1,155,000 1,050,000
42 CT-SCAN Cranium/Kepala Dengan 2,040,000 2,040,000 2,468,400 2,244,000 2,040,000
43 CT-SCAN Cranium/Kepala Polos 1,170,000 1,170,000 1,415,700 1,287,000 1,170,000
44 CT-SCAN Facial 3 Dimensi 2,376,000 2,376,000 2,874,960 2,613,600 2,376,000
45 CT-SCAN Kepala 3 Dimensi 2,376,000 2,376,000 2,874,960 2,613,600 2,376,000
46 CT-SCAN KEPALA DENGAN TRAU 1,287,000 1,287,000 1,557,270 1,415,700 1,287,000
47 CT-SCAN Larynx Dengan Kontras 1,680,000 1,680,000 2,032,800 1,848,000 1,680,000
48 CT-SCAN Larynx Tanpa Kontras 1,050,000 1,050,000 1,270,500 1,155,000 1,050,000
49 CT-SCAN Nasofaring Dengan Kontr 2,340,000 2,340,000 2,831,400 2,574,000 2,340,000
50 CT-SCAN Nasofaring Tanpa Kontra 1,740,000 1,740,000 2,105,400 1,914,000 1,740,000
CLASS VIP ICU HCU PERINATOLOGI PERINA SEHAT ISOLASI B ISOLASI A
409,948 409,948 409,948 372,680 308,000 372,680 372,680
468,512 468,512 468,512 425,920 352,000 425,920 425,920
197,654 197,654 197,654 179,685 148,500 179,685 179,685
409,948 409,948 409,948 372,680 308,000 372,680 372,680
241,577 241,577 241,577 219,615 181,500 219,615 219,615
409,948 409,948 409,948 372,680 308,000 372,680 372,680
241,577 241,577 241,577 219,615 181,500 219,615 219,615
585,640 585,640 585,640 532,400 440,000 532,400 532,400
409,948 409,948 409,948 372,680 308,000 372,680 372,680
241,577 241,577 241,577 219,615 181,500 219,615 219,615
409,948 409,948 409,948 372,680 308,000 372,680 372,680
241,577 241,577 241,577 219,615 181,500 219,615 219,615
248,897 248,897 248,897 226,270 187,000 226,270 226,270
1,830,125 1,830,125 1,830,125 1,663,750 1,375,000 1,663,750 1,663,750
2,928,200 2,928,200 2,928,200 2,662,000 2,200,000 2,662,000 2,662,000
109,808 109,808 109,808 99,825 82,500 99,825 99,825
270,859 270,859 270,859 246,235 203,500 246,235 246,235
256,218 256,218 256,218 232,925 192,500 232,925 232,925
385,058 385,058 385,058 350,053 289,300 350,053 350,053
667,630 667,630 667,630 606,936 501,600 606,936 606,936
667,630 667,630 667,630 606,936 501,600 606,936 606,936
395,307 395,307 395,307 359,370 297,000 359,370 359,370
241,577 241,577 241,577 219,615 181,500 219,615 219,615
241,577 241,577 241,577 219,615 181,500 219,615 219,615
366,025 366,025 366,025 332,750 275,000 332,750 332,750
268,955 268,955 268,955 244,505 202,070 244,505 244,505
424,589 424,589 424,589 385,990 319,000 385,990 385,990
268,955 268,955 268,955 244,505 202,070 244,505 244,505
424,589 424,589 424,589 385,990 319,000 385,990 385,990
2,461,152 2,461,152 2,461,152 2,237,411 1,849,100 2,237,411 2,237,411
4,703,421 4,703,421 4,703,421 4,275,838 3,533,750 4,275,838 4,275,838
282,571 282,571 282,571 256,883 212,300 256,883 256,883
241,577 241,577 241,577 219,615 181,500 219,615 219,615
409,948 409,948 409,948 372,680 308,000 372,680 372,680
241,577 241,577 241,577 219,615 181,500 219,615 219,615
5,534,298 5,534,298 5,534,298 5,031,180 4,158,000 5,031,180 5,031,180
3,780,000 3,780,000 3,780,000 3,780,000 3,780,000 3,780,000 3,780,000
4,216,608 4,216,608 4,216,608 3,833,280 3,168,000 3,833,280 3,833,280
4,216,608 4,216,608 4,216,608 3,833,280 3,168,000 3,833,280 3,833,280
2,236,080 2,236,080 2,236,080 2,032,800 1,680,000 2,032,800 2,032,800
1,397,550 1,397,550 1,397,550 1,270,500 1,050,000 1,270,500 1,270,500
2,715,240 2,715,240 2,715,240 2,468,400 2,040,000 2,468,400 2,468,400
1,557,270 1,557,270 1,557,270 1,415,700 1,170,000 1,415,700 1,415,700
3,162,456 3,162,456 3,162,456 2,874,960 2,376,000 2,874,960 2,874,960
3,162,456 3,162,456 3,162,456 2,874,960 2,376,000 2,874,960 2,874,960
1,712,997 1,712,997 1,712,997 1,557,270 1,287,000 1,557,270 1,557,270
2,236,080 2,236,080 2,236,080 2,032,800 1,680,000 2,032,800 2,032,800
1,397,550 1,397,550 1,397,550 1,270,500 1,050,000 1,270,500 1,270,500
3,114,540 3,114,540 3,114,540 2,831,400 2,340,000 2,831,400 2,831,400
2,315,940 2,315,940 2,315,940 2,105,400 1,740,000 2,105,400 2,105,400
CLASS VIP A CLASS I A NICU
409,948 372,680 409,948
468,512 425,920 468,512
197,654 179,685 197,654
409,948 372,680 409,948
241,577 219,615 241,577
409,948 372,680 409,948
241,577 219,615 241,577
585,640 532,400 585,640
409,948 372,680 409,948
241,577 219,615 241,577
409,948 372,680 409,948
241,577 219,615 241,577
248,897 226,270 248,897
1,830,125 1,663,750 1,830,125
2,928,200 2,662,000 2,928,200
109,808 99,825 109,808
270,859 246,235 270,859
256,218 232,925 256,218
385,058 350,053 385,058
667,630 606,936 667,630
667,630 606,936 667,630
395,307 359,370 395,307
241,577 219,615 241,577
241,577 219,615 241,577
366,025 332,750 366,025
268,955 244,505 268,955
424,589 385,990 424,589
268,955 244,505 268,955
424,589 385,990 424,589
2,461,152 2,237,411 2,461,152
4,703,421 4,275,838 4,703,421
282,571 256,883 282,571
241,577 219,615 241,577
409,948 372,680 409,948
241,577 219,615 241,577
5,534,298 5,031,180 5,534,298
3,780,000 3,780,000 3,780,000
4,216,608 3,833,280 4,216,608
4,216,608 3,833,280 4,216,608
2,236,080 2,032,800 2,236,080
1,397,550 1,270,500 1,397,550
2,715,240 2,468,400 2,715,240
1,557,270 1,415,700 1,557,270
3,162,456 2,874,960 3,162,456
3,162,456 2,874,960 3,162,456
1,712,997 1,557,270 1,712,997
2,236,080 2,032,800 2,236,080
1,397,550 1,270,500 1,397,550
3,114,540 2,831,400 3,114,540
2,315,940 2,105,400 2,315,940
 51 CT-SCAN Orbita Dengan Kontras 2,340,000 2,340,000 2,831,400 2,574,000 2,340,000
52 CT-SCAN Orbita Tanpa Kontras 1,740,000 1,740,000 2,105,400 1,914,000 1,740,000
53 CT-SCAN Sinus Paranasal Dengan 2,340,000 2,340,000 2,831,400 2,574,000 2,340,000
54 CT-SCAN Sinus Paranasal Tanpa Ko1,740,000 1,740,000 2,105,400 1,914,000 1,740,000
55 CT-SCAN Telinga Dengan Kontras 2,340,000 2,340,000 2,831,400 2,574,000 2,340,000
56 CT-SCAN Telinga Tanpa Kontras 1,740,000 1,740,000 2,105,400 1,914,000 1,740,000
57 CT-SCAN Thoracal/Lumbal Spine D 2,340,000 2,340,000 2,831,400 2,574,000 2,340,000
58 CT-SCAN Thoracal/Lumbal Spine Ta1,740,000 1,740,000 2,105,400 1,914,000 1,740,000
59 CT-SCAN Thorax 3 Dimensi 3,960,000 3,960,000 4,791,600 4,356,000 3,960,000
60 CT-SCAN Thorax Dengan Kontras 3,480,000 3,480,000 3,480,000 3,480,000 3,480,000
61 CT-SCAN Thorax Tanpa Kontras 1,920,000 1,920,000 2,323,200 2,112,000 1,920,000
62 CT-SCAN Thyroid Dengan Kontras 2,340,000 2,340,000 2,831,400 2,574,000 2,340,000
63 CT-SCAN Thyroid Tanpa Kontras 1,740,000 1,740,000 2,105,400 1,914,000 1,740,000
64 CT-SCAN Whole Abdomen Dengan 4,316,400 4,316,400 5,222,844 4,748,040 4,316,400
65 CT-SCAN Whole Abdomen Dengan K7,200,000 7,200,000 7,200,000 7,200,000 7,200,000
66 CT-SCAN Whole Abdomen Tanpa Ko3,406,200 3,406,200 4,121,502 3,746,820 3,406,200
67 Cystografi 660,000 660,000 798,600 726,000 660,000
68 Dental Regio 79,200 79,200 95,832 87,120 79,200
69 ECHO Color Doppler 667,000 667,000 807,070 733,700 667,000
70 Elbow Joint Ka & Ki 308,000 308,000 372,680 338,800 308,000
71 Elbow Joint Ka/Ki 181,500 181,500 219,615 199,650 181,500
72 EMG 1,168,200 1,168,200 1,413,522 1,285,020 1,168,200
73 Femur Ka & Ki 308,000 308,000 372,680 338,800 308,000
74 Femur Ka/Ki 181,500 181,500 219,615 199,650 181,500
75 Film Rontgen per Lembar 66,000 66,000 79,860 72,600 66,000
76 Film USG 23,000 23,000 27,830 25,300 23,000
77 Fistulografi 791,450 791,450 957,655 870,595 791,450
78 Flebografi 791,450 791,450 957,655 870,595 791,450
79 Follow Through 597,850 597,850 723,399 657,635 597,850
80 Hip Joint Ka & Ki 308,000 308,000 372,680 338,800 308,000
81 Hip Joint Ka/Ki 181,500 181,500 219,615 199,650 181,500
82 HSG 753,500 753,500 911,735 828,850 753,500
83 Humerus Ka & Ki 308,000 308,000 372,680 338,800 308,000
84 Humerus Ka / Ki 181,500 181,500 219,615 199,650 181,500
85 Jasa Dokter Anastesi CT-SCAN 621,500 621,500 621,500 621,500 621,500
86 Jasa Dokter Radiologi Cito 132,000 132,000 132,000 132,000 132,000
87 Knee Joint Ka & Ki 308,000 308,000 372,680 338,800 308,000
88 Knee Joint Ka/Ki 181,500 181,500 219,615 199,650 181,500
89 Lumbosacral 2 Posisi 308,000 308,000 372,680 338,800 308,000
90 Lumbosacral 4 Posisi 440,000 440,000 532,400 484,000 440,000
91 Mammografi 309,100 309,100 374,011 340,010 309,100
92 Mandibula Ka/Ki 165,000 165,000 199,650 181,500 165,000
93 Manus Ka & Ki 308,000 308,000 372,680 338,800 308,000
94 Manus Ka/Ki 181,500 181,500 219,615 199,650 181,500
95 Mastoid 231,000 231,000 279,510 254,100 231,000
96 MRI Kepala Kontras + Anatesi 5,389,450 5,389,450 5,389,450 5,389,450 5,389,450
97 MRI Lumbosacral Kontras 5,632,000 5,632,000 5,632,000 5,632,000 5,632,000
98 Myelografi 983,950 983,950 1,190,580 1,082,345 983,950
99 Nasal 198,000 198,000 239,580 217,800 198,000
100 Oesophagogram 440,000 440,000 532,400 484,000 440,000
101 Orbita 198,000 198,000 239,580 217,800 198,000
102 Os. Sacrum 214,500 214,500 259,545 235,950 214,500
103 PAKET PANORAMIC DAN CEPHAL 302,500 302,500 366,025 332,750 302,500
104 PANORAMIC 198,000 198,000 239,580 217,800 198,000
3,114,540 3,114,540 3,114,540 2,831,400 2,340,000 2,831,400 2,831,400
2,315,940 2,315,940 2,315,940 2,105,400 1,740,000 2,105,400 2,105,400
3,114,540 3,114,540 3,114,540 2,831,400 2,340,000 2,831,400 2,831,400
2,315,940 2,315,940 2,315,940 2,105,400 1,740,000 2,105,400 2,105,400
3,114,540 3,114,540 3,114,540 2,831,400 2,340,000 2,831,400 2,831,400
2,315,940 2,315,940 2,315,940 2,105,400 1,740,000 2,105,400 2,105,400
3,114,540 3,114,540 3,114,540 2,831,400 2,340,000 2,831,400 2,831,400
2,315,940 2,315,940 2,315,940 2,105,400 1,740,000 2,105,400 2,105,400
5,270,760 5,270,760 5,270,760 4,791,600 3,960,000 4,791,600 4,791,600
3,480,000 3,480,000 3,480,000 3,480,000 3,480,000 3,480,000 3,480,000
2,555,520 2,555,520 2,555,520 2,323,200 1,920,000 2,323,200 2,323,200
3,114,540 3,114,540 3,114,540 2,831,400 2,340,000 2,831,400 2,831,400
2,315,940 2,315,940 2,315,940 2,105,400 1,740,000 2,105,400 2,105,400
5,745,128 5,745,128 5,745,128 5,222,844 4,316,400 5,222,844 5,222,844
7,200,000 7,200,000 7,200,000 7,200,000 7,200,000 7,200,000 7,200,000
4,533,652 4,533,652 4,533,652 4,121,502 3,406,200 4,121,502 4,121,502
878,460 878,460 878,460 798,600 660,000 798,600 798,600
105,415 105,415 105,415 95,832 79,200 95,832 95,832
887,777 887,777 887,777 807,070 667,000 807,070 807,070
409,948 409,948 409,948 372,680 308,000 372,680 372,680
241,577 241,577 241,577 219,615 181,500 219,615 219,615
1,554,874 1,554,874 1,554,874 1,413,522 1,168,200 1,413,522 1,413,522
409,948 409,948 409,948 372,680 308,000 372,680 372,680
241,577 241,577 241,577 219,615 181,500 219,615 219,615
87,846 87,846 87,846 79,860 66,000 79,860 79,860
30,613 30,613 30,613 27,830 23,000 27,830 27,830
1,053,420 1,053,420 1,053,420 957,655 791,450 957,655 957,655
1,053,420 1,053,420 1,053,420 957,655 791,450 957,655 957,655
795,738 795,738 795,738 723,399 597,850 723,399 723,399
409,948 409,948 409,948 372,680 308,000 372,680 372,680
241,577 241,577 241,577 219,615 181,500 219,615 219,615
1,002,909 1,002,909 1,002,909 911,735 753,500 911,735 911,735
409,948 409,948 409,948 372,680 308,000 372,680 372,680
241,577 241,577 241,577 219,615 181,500 219,615 219,615
621,500 621,500 621,500 621,500 621,500 621,500 621,500
132,000 132,000 132,000 132,000 132,000 132,000 132,000
409,948 409,948 409,948 372,680 308,000 372,680 372,680
241,577 241,577 241,577 219,615 181,500 219,615 219,615
409,948 409,948 409,948 372,680 308,000 372,680 372,680
585,640 585,640 585,640 532,400 440,000 532,400 532,400
411,412 411,412 411,412 374,011 309,100 374,011 374,011
219,615 219,615 219,615 199,650 165,000 199,650 199,650
409,948 409,948 409,948 372,680 308,000 372,680 372,680
241,577 241,577 241,577 219,615 181,500 219,615 219,615
307,461 307,461 307,461 279,510 231,000 279,510 279,510
5,389,450 5,389,450 5,389,450 5,389,450 5,389,450 5,389,450 5,389,450
5,632,000 5,632,000 5,632,000 5,632,000 5,632,000 5,632,000 5,632,000
1,309,637 1,309,637 1,309,637 1,190,580 983,950 1,190,580 1,190,580
263,538 263,538 263,538 239,580 198,000 239,580 239,580
585,640 585,640 585,640 532,400 440,000 532,400 532,400
263,538 263,538 263,538 239,580 198,000 239,580 239,580
285,500 285,500 285,500 259,545 214,500 259,545 259,545
402,628 402,628 402,628 366,025 302,500 366,025 366,025
263,538 263,538 263,538 239,580 198,000 239,580 239,580
3,114,540 2,831,400 3,114,540
2,315,940 2,105,400 2,315,940
3,114,540 2,831,400 3,114,540
2,315,940 2,105,400 2,315,940
3,114,540 2,831,400 3,114,540
2,315,940 2,105,400 2,315,940
3,114,540 2,831,400 3,114,540
2,315,940 2,105,400 2,315,940
5,270,760 4,791,600 5,270,760
3,480,000 3,480,000 3,480,000
2,555,520 2,323,200 2,555,520
3,114,540 2,831,400 3,114,540
2,315,940 2,105,400 2,315,940
5,745,128 5,222,844 5,745,128
7,200,000 7,200,000 7,200,000
4,533,652 4,121,502 4,533,652
878,460 798,600 878,460
105,415 95,832 105,415
887,777 807,070 887,777
409,948 372,680 409,948
241,577 219,615 241,577
1,554,874 1,413,522 1,554,874
409,948 372,680 409,948
241,577 219,615 241,577
87,846 79,860 87,846
30,613 27,830 30,613
1,053,420 957,655 1,053,420
1,053,420 957,655 1,053,420
795,738 723,399 795,738
409,948 372,680 409,948
241,577 219,615 241,577
1,002,909 911,735 1,002,909
409,948 372,680 409,948
241,577 219,615 241,577
621,500 621,500 621,500
132,000 132,000 132,000
409,948 372,680 409,948
241,577 219,615 241,577
409,948 372,680 409,948
585,640 532,400 585,640
411,412 374,011 411,412
219,615 199,650 219,615
409,948 372,680 409,948
241,577 219,615 241,577
307,461 279,510 307,461
5,389,450 5,389,450 5,389,450
5,632,000 5,632,000 5,632,000
1,309,637 1,190,580 1,309,637
263,538 239,580 263,538
585,640 532,400 585,640
263,538 239,580 263,538
285,500 259,545 285,500
402,628 366,025 402,628
263,538 239,580 263,538
105 Pedis ka & ki 308,000 308,000 372,680 338,800 308,000
106 Pedis ka / ki 181,500 181,500 219,615 199,650 181,500
107 Pelvis / Cocxae 165,000 165,000 199,650 181,500 165,000
108 RAD MCU PAKET A 1 1 1 1 1
109 RAD MCU PAKET B 1 1 1 1 1
110 RAD MCU PAKET C 1 1 1 1 1
111 RPG ka & ki 968,000 968,000 1,171,280 1,064,800 968,000
112 RPG ka / ki 616,000 616,000 745,360 677,600 616,000
113 Scapula ka / ki 181,500 181,500 219,615 199,650 181,500
114 SHOULDER JOINT KA & KI 308,000 308,000 372,680 338,800 308,000
115 SHOULDER JOINT KA / KI 181,500 181,500 219,615 199,650 181,500
116 Sialografi 791,450 791,450 957,655 870,595 791,450
117 Sinus P (3 Posisi) 286,000 286,000 346,060 314,600 286,000
118 Sinus Paranasalis 2 Posisi 214,500 214,500 259,545 235,950 214,500
119 Sternum 165,000 165,000 199,650 181,500 165,000
120 Temporo Mandibula Joint 275,000 275,000 332,750 302,500 275,000
121 Thoracolumbal 2 Posisi 302,500 302,500 366,025 332,750 302,500
122 Thorax MTL 103,400 103,400 125,114 113,740 103,400
123 Thorax Oblique ka & ki 183,700 183,700 222,277 202,070 183,700
124 Thorax PA & Lateral 198,000 198,000 239,580 217,800 198,000
125 ThoraxPa/Lateral 148,500 148,500 179,685 163,350 148,500
126 Uretrografi 968,000 968,000 1,171,280 1,064,800 968,000
127 USG Abdomen C Doppler 687,125 687,125 831,421 755,838 687,125
128 USG Abdomen H P 442,750 442,750 535,728 487,025 442,750
129 USG Genital Doppler 1,127,000 1,127,000 1,363,670 1,239,700 1,127,000
130 USG Genital H P 402,500 402,500 487,025 442,750 402,500
131 USG JAR. LUNAK C DOPPLER 1,127,000 1,127,000 1,363,670 1,239,700 1,127,000
132 USG KEPALA DOPPLER 1,127,000 1,127,000 1,363,670 1,239,700 1,127,000
133 USG KEPALA H P 575,000 575,000 695,750 632,500 575,000
134 USG Mammae C Doppler 687,700 687,700 832,117 756,470 687,700
135 USG Mammae H P 402,500 402,500 487,025 442,750 402,500
136 USG Thorax 345,000 345,000 417,450 379,500 345,000
137 USG Tiroid Doppler 687,700 687,700 832,117 756,470 687,700
138 USG Tiroid H P 402,500 402,500 487,025 442,750 402,500
139 USG Vaskuler C Doppler 728,525 728,525 881,515 801,378 728,525
140 Waters Position 187,000 187,000 226,270 205,700 187,000
141 Wrist Joint ka & ki 308,000 308,000 372,680 338,800 308,000
142 Wrist Joint ka / ki 181,500 181,500 219,615 199,650 181,500
143 Zygomaticus ka & ki 308,000 308,000 372,680 338,800 308,000
144 Zygomaticus ka / ki 181,500 181,500 219,615 199,650 181,500
 409,948 409,948 409,948 372,680 308,000 372,680 372,680
241,577 241,577 241,577 219,615 181,500 219,615 219,615
219,615 219,615 219,615 199,650 165,000 199,650 199,650
1 1 1 1 1 1 1
1 1 1 1 1 1 1
1 1 1 1 1 1 1
1,288,408 1,288,408 1,288,408 1,171,280 968,000 1,171,280 1,171,280
819,896 819,896 819,896 745,360 616,000 745,360 745,360
241,577 241,577 241,577 219,615 181,500 219,615 219,615
409,948 409,948 409,948 372,680 308,000 372,680 372,680
241,577 241,577 241,577 219,615 181,500 219,615 219,615
1,053,420 1,053,420 1,053,420 957,655 791,450 957,655 957,655
380,666 380,666 380,666 346,060 286,000 346,060 346,060
285,500 285,500 285,500 259,545 214,500 259,545 259,545
219,615 219,615 219,615 199,650 165,000 199,650 199,650
366,025 366,025 366,025 332,750 275,000 332,750 332,750
402,628 402,628 402,628 366,025 302,500 366,025 366,025
137,625 137,625 137,625 125,114 103,400 125,114 125,114
244,505 244,505 244,505 222,277 183,700 222,277 222,277
263,538 263,538 263,538 239,580 198,000 239,580 239,580
197,654 197,654 197,654 179,685 148,500 179,685 179,685
1,288,408 1,288,408 1,288,408 1,171,280 968,000 1,171,280 1,171,280
914,563 914,563 914,563 831,421 687,125 831,421 831,421
589,300 589,300 589,300 535,728 442,750 535,728 535,728
1,500,037 1,500,037 1,500,037 1,363,670 1,127,000 1,363,670 1,363,670
535,728 535,728 535,728 487,025 402,500 487,025 487,025
1,500,037 1,500,037 1,500,037 1,363,670 1,127,000 1,363,670 1,363,670
1,500,037 1,500,037 1,500,037 1,363,670 1,127,000 1,363,670 1,363,670
765,325 765,325 765,325 695,750 575,000 695,750 695,750
915,329 915,329 915,329 832,117 687,700 832,117 832,117
535,728 535,728 535,728 487,025 402,500 487,025 487,025
459,195 459,195 459,195 417,450 345,000 417,450 417,450
915,329 915,329 915,329 832,117 687,700 832,117 832,117
535,728 535,728 535,728 487,025 402,500 487,025 487,025
969,667 969,667 969,667 881,515 728,525 881,515 881,515
248,897 248,897 248,897 226,270 187,000 226,270 226,270
409,948 409,948 409,948 372,680 308,000 372,680 372,680
241,577 241,577 241,577 219,615 181,500 219,615 219,615
409,948 409,948 409,948 372,680 308,000 372,680 372,680
241,577 241,577 241,577 219,615 181,500 219,615 219,615
 409,948 372,680 409,948
241,577 219,615 241,577
219,615 199,650 219,615
1 1 1
1 1 1
1 1 1
1,288,408 1,171,280 1,288,408
819,896 745,360 819,896
241,577 219,615 241,577
409,948 372,680 409,948
241,577 219,615 241,577
1,053,420 957,655 1,053,420
380,666 346,060 380,666
285,500 259,545 285,500
219,615 199,650 219,615
366,025 332,750 366,025
402,628 366,025 402,628
137,625 125,114 137,625
244,505 222,277 244,505
263,538 239,580 263,538
197,654 179,685 197,654
1,288,408 1,171,280 1,288,408
914,563 831,421 914,563
589,300 535,728 589,300
1,500,037 1,363,670 1,500,037
535,728 487,025 535,728
1,500,037 1,363,670 1,500,037
1,500,037 1,363,670 1,500,037
765,325 695,750 765,325
915,329 832,117 915,329
535,728 487,025 535,728
459,195 417,450 459,195
915,329 832,117 915,329
535,728 487,025 535,728
969,667 881,515 969,667
248,897 226,270 248,897
409,948 372,680 409,948
241,577 219,615 241,577
409,948 372,680 409,948
241,577 219,615 241,577