Radiologi
| CERVICAL OBLIQUE | - | Rp. 140.000,- |
| HUMERUS DEXTRA | - | Rp. 140.000,- |
| BOF 3 POSISI | - | Rp. 300.000,- |
| USG ABDOMEN BAWAH - SAM HUSADA | - | Rp. 540.000,- |
| CT SCAN KEPALA TANPA KONTRAS - GAMBIRAN | - | Rp. 1.080.000,- |
| USG ABDOMEN ATAS - BHAYANGKARA | - | Rp. 360.000,- |
| USG THORAX - BHAYANGKARA | - | Rp. 360.000,- |
| THORAX - RS. ARGA HUSADA | - | Rp. 200.000,- |
| SKULL AP - RSUD GAMBIRAN | - | Rp. 157.000,- |
| ANTEBRACHI SINISTRA | - | Rp. 140.000,- |
| FEMUR SIN | - | Rp. 150.000,- |
| BOF/KUB | - | Rp. 145.000,- |
| CRURIS DEX | - | Rp. 150.000,- |
| USG ABDOMEN TOTAL - AHMAD DAHLAN | - | Rp. 510.000,- |
| USG ABDOMEN TOTAL - ULTRA MEDICA | - | Rp. 720.000,- |
| USG UROLOGI - GAMBIRAN | - | Rp. 180.000,- |
| CT SCAN KEPALA TANPA KONTRAS - SAM HUSADA | - | Rp. 1.200.000,- |
| CT-SCAN GENUE - AHMAD DAHLAN | - | Rp. 1.200.000,- |
| PELVIS - RSUD GAMBIRAN | - | Rp. 167.200,- |
| V CERVICAL AP DAN LAT - RSUD GAMBIRAN | - | Rp. 259.000,- |
| HUMERUS SINISTRA | - | Rp. 140.000,- |
| THORACO LUMBAL | - | Rp. 180.000,- |
| WATERS | - | Rp. 140.000,- |
| WRIST JOINT DEXTRA | - | Rp. 140.000,- |
| PELVIS | - | Rp. 145.000,- |
| USG UROLOGI - AHMAD DAHLAN | - | Rp. 546.000,- |
| USG UROLOGI - ULTRA MEDICA | - | Rp. 480.000,- |
| USG ABDOMEN TOTAL - BHAYANGKARA | - | Rp. 480.000,- |
| USG THORAX - AHMAD DAHLAN | - | Rp. 390.000,- |
| PHANORAMIC ULTRA MEDICA | - | Rp. 330.000,- |
| THORAX AP DAN LAT - RSUD GAMBIRAN | - | Rp. 279.400,- |
| MANUS SINISTRA | - | Rp. 140.000,- |
| CRURIS SIN | - | Rp. 150.000,- |
| SKULL AP+LATERAL | - | Rp. 140.000,- |
| PEDIS DEX | - | Rp. 140.000,- |
| JASA PELAYANAN RADIOLOGI | - | Rp. 40.000,- |
| USG ABDOMEN ATAS - SAM HUSADA | - | Rp. 630.000,- |
| USG ABDOMEN BAWAH - GAMBIRAN | - | Rp. 180.000,- |
| USG UROLOGI - Bhayangkara | - | Rp. 360.000,- |
| USG THORAX - ULTRA MEDICA | - | Rp. 540.000,- |
| USG ABDOMEN TOTAL - GAMBIRAN | - | Rp. 305.000,- |
| SKULL LAT - RSUD GAMBIRAN | - | Rp. 157.000,- |
| ANTEBRACHI DEXTRA | - | Rp. 140.000,- |
| ELBOW SIN | - | Rp. 140.000,- |
| BOF 2 POSISI | - | Rp. 180.000,- |
| GENU DEX | - | Rp. 140.000,- |
| USG ABDOMEN BAWAH - AHMAD DAHLAN | - | Rp. 390.000,- |
| USG ABDOMEN BAWAH - ULTRA MEDICA | - | Rp. 510.000,- |
| CT SCAN KEPALA KONTRAS - BHAYANGKARA | - | Rp. 2.040.000,- |
| LUMBO SACRAL OBLIQUE | - | Rp. 180.000,- |
| USG UPPER LOW ABDOMEN (SIMA LAB) | - | Rp. 1.068.000,- |
| THORAX PA - RSUD GAMBIRAN | - | Rp. 167.200,- |
| CLAVICULA DEX | - | Rp. 150.000,- |
| PEDIS SIN | - | Rp. 140.000,- |
| BABY GRAM | - | Rp. 250.000,- |
| CERVICAL AP+LATERAL | - | Rp. 140.000,- |
| SHOULDER JOINT DEXTRA | - | Rp. 140.000,- |
| ELBOW DEX | - | Rp. 140.000,- |
| USG ABDOMEN TOTAL - SAM HUSADA | - | Rp. 840.000,- |
| CT SCAN KEPALA KONTRAS - GAMBIRAN | - | Rp. 2.400.000,- |
| USG ABDOMEN BAWAH - BHAYANGKARA | - | Rp. 360.000,- |
| USG THORAX - SAM HUSADA | - | Rp. 510.000,- |
| THORAX - SAM HUASADA | - | Rp. 210.000,- |
| SKULL AP DAN LAT - RSUD GAMBIRAN | - | Rp. 259.000,- |
| WRIST JOINT SINISTRA | - | Rp. 140.000,- |
| GENU SIN | - | Rp. 140.000,- |
| THORACALIS AP+LATERAL | - | Rp. 150.000,- |
| ANKLE DEX | - | Rp. 140.000,- |
| LUMBO SACRAL AP LATERAL | - | Rp. 180.000,- |
| USG ABDOMEN UROLOGI - SAM HUSADA | - | Rp. 330.000,- |
| USG ABDOMEN ATAS - GAMBIRAN | - | Rp. 180.000,- |
| CT SCAN KEPALA KONTRAS - SAM HUSADA | - | Rp. 2.400.000,- |
| CT SCAN KEPALA (KONTRAS) - AHMAD DAHLAN | - | Rp. 1.800.000,- |
| BOF - RSUD Gambiran | - | Rp. 167.200,- |
| V CERVICAL AP/LAT- RSUD GAMBIRAN | - | Rp. 157.000,- |
| SHOULDER JOINT SINISTRA | - | Rp. 140.000,- |
| SCOLIOSIS | - | Rp. 200.000,- |
| MANUS DEXTRA | - | Rp. 140.000,- |
| FEMUR DEX | - | Rp. 150.000,- |
| USG ABDOMEN ATAS - AHMAD DAHLAN | - | Rp. 390.000,- |
| USG ABDOMEN ATAS - ULTRA MEDICA | - | Rp. 570.000,- |
| CT SCAN KEPALA TANPA KONTRAS - BHAYANGKARA | - | Rp. 990.000,- |
| CT SCAN KEPALA TANPA KONTRAS-AHMAD DAHLAN | - | Rp. 1.020.000,- |
| USG THORAX - RSUD GAMBIRAN | - | Rp. 360.000,- |
| THORAX LAT - RSUD GAMBIRAN | - | Rp. 167.200,- |
| CLAVICULA SIN | - | Rp. 150.000,- |
| ANKLE SIN | - | Rp. 140.000,- |