XI. TARIF RADIOLOGI | ||||||||
No | Jenis Pelayanan | Ruang | BAKHP | Jasa Pelayanan | Jasa RS | Tarif | ||
1 | Foto polos | VIP / Utama | 26,250 | 27,500 | 8,250 | Rp 62,000 | ||
Kelas I | 26,250 | 21,000 | 6,300 | Rp 53,550 | ||||
Kelas II /R.Jalan | 26,250 | 16,000 | 4,800 | Rp 47,050 | ||||
ICU | 26,250 | 21,000 | 6,300 | Rp 53,550 | ||||
Kelas III | 26,250 | 10,000 | - | Rp 36,250 | ||||
2 | Kontras | Rp - | ||||||
a. Sederhana (Sistograf) | VIP / Utama | 26,250 | 95,000 | 28,500 | Rp 149,750 | |||
Kelas I | 26,250 | 80,000 | 24,000 | Rp 130,250 | ||||
Kelas II /R.Jalan | 26,250 | 75,000 | 22,500 | Rp 123,750 | ||||
ICU | 26,250 | 80,000 | 24,000 | Rp 130,250 | ||||
Kelas III | 26,250 | 50,000 | - | Rp 76,250 | ||||
b. Besar (IVP, Colon in loop) | VIP / Utama | 191,000 | 110,000 | 33,000 | Rp 334,000 | |||
Kelas I | 191,000 | 95,000 | 28,500 | Rp 314,500 | ||||
Kelas II /R.Jalan | 191,000 | 90,000 | 27,000 | Rp 308,000 | ||||
ICU | 191,000 | 95,000 | 28,500 | Rp 314,500 | ||||
Kelas III | 191,000 | 60,000 | - | Rp 251,000 | ||||
3 | USG | |||||||
a. USG | VIP / Utama | 5,500 | 85,000 | 25,500 | Rp 116,000 | |||
Kelas I | 5,500 | 65,000 | 19,500 | Rp 90,000 | ||||
Kelas II /R.Jalan | 5,500 | 50,000 | 15,000 | Rp 70,500 | ||||
ICU | 5,500 | 65,000 | 19,500 | Rp 90,000 | ||||
Kelas III | 5,500 | 30,000 | - | Rp 35,500 | ||||
b. USG Doppler | VIP / Utama | 20,500 | 100,000 | 30,000 | Rp 150,500 | |||
Kelas I | 20,500 | 90,000 | 27,000 | Rp 137,500 | ||||
Kelas II /R.Jalan | 20,500 | 80,000 | 24,000 | Rp 124,500 | ||||
ICU | 20,500 | 90,000 | 27,000 | Rp 137,500 | ||||
Kelas III | 20,500 | 55,000 | - | Rp 75,500 | ||||
c. Pemeriksaan Khusus | ||||||||
1. Gigi | Rawat Jalan | 17,000 | 3,000 | 900 | Rp 20,900 | |||
Swasta | 17,000 | 4,000 | 1,200 | Rp 22,200 | ||||
2. Panaromic | Rawat Jalan | 17,000 | 40,000 | 12,000 | Rp 69,000 | |||
Swasta | 17,000 | 50,000 | 15,000 | Rp 82,000 |
Pelayanan Instalasi Radiologi
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