| NO | TINDAKAN | KELAS | |||
| (Normal = 2 hari / SC = 3 hari) | VIP | I | II | III | |
| 1 | Persalinan Normal (dr. Sp.OG) | 15,200,000 | 12,575,000 | 10,750,000 | 8,800,000 |
| 2 | Persalinan Kembar (dr. Sp.OG) | 17,500,000 | 14,875,000 | 12,850,000 | 10,750,000 |
| 3 | Operasi Sectio Caesar | 26,075,000 | 19,500,000 | 17,550,000 | 14,150,000 |
| 4 | Operasi Sectio Caesar Kembar | 28,535,000 | 21,900,000 | 19,875,000 | 16,575,000 |
| 5 | Operasi Myomektomy & Kistektomy | 24,000,000 | 17,750,000 | 14,200,000 | 10,975,000 |
| 6 | Operasi Histerktomy | 25,375,000 | 18,775,000 | 15,100,000 | 11,900,000 |
| 7 | Curetage | 9,075,000 | 7,550,000 | 6,075,000 | 5,075,000 |
| 8 | Appendiktomy | 20,700,000 | 15,000,000 | 12,250,000 | 9,500,000 |
| 9 | Kamar Perawatan | 900,000 | 700,000 | 400,000 | 300,000 |
| 10 | Jasa Konsultasi Dokter Umum | 225,000 | 200,000 | 175,000 | 150,000 |
| 11 | Jasa Konsultasi Dokter Spesialis | 350,000 | 300,000 | 250,000 | 200,000 |
Note :
* Harga diatas belum termasuk biaya penunjang (Obat, Laboratorium, Radiologi, ECG, USG)
* Ada tambahan jika ada penyulit
* Harga dapat berubah sewaktu-waktu
