Tarif Pemeriksaan Laboratorium Kesehatan Daerah
| NO |
JENIS PEMERIKSAAN |
PARAMETER |
TARIF (Rp) |
| 1 |
Hematologi |
Haemoglobin |
10.000,00 |
| 2 |
Hematologi |
Lekosit |
8.000,00 |
| 3 |
Hematologi |
Eristrosit |
8.000,00 |
| 4 |
Hematologi |
Trombosit |
9.000,00 |
| 5 |
Hematologi |
Retikulosit |
9.000,00 |
| 6 |
Hematologi |
Laju endap darah |
8.000,00 |
| 7 |
Hematologi |
Diff count/hitung jenis |
8.000,00 |
| 8 |
Hematologi |
Apus Darah Tepi |
175.000,00 |
| 9 |
Hematologi |
Ferritin |
300.000,00 |
| 10 |
Hematologi |
TIBC (Total Iron Binding Capacity) |
80.000,00 |
| 11 |
Hematologi |
Hematokrit |
10.000,00 |
| 12 |
Hematologi |
Waktu pembekuan |
8.000,00 |
| 13 |
Hematologi |
Waktu pendarahan |
7.000,00 |
| 14 |
Hematologi |
Darah rutin |
50.000,00 |
| 15 |
Hematologi |
Rumple leed |
7.000,00 |
| 16 |
Hematologi |
CD4 |
210.000,00 |
| 17 |
Mikrobiologi |
Preparat BTA |
15.000,00 |
| 18 |
Mikrobiologi |
Preparat Kusta |
15.000,00 |
| 19 |
Mikrobiologi |
Jamur KOH |
10.000,00 |
| 20 |
Mikrobiologi |
Preparat Filariasis |
10.000,00 |
| 21 |
Mikrobiologi |
Preparat GRAM |
20.000,00 |
| 22 |
Mikrobiologi |
Preparat Malaria/ DDR |
15.000,00 |
| 23 |
Mikrobiologi |
Dipteri |
15.000,00 |
| 24 |
Urine |
Reduksi Urine |
10.000,00 |
| 25 |
Urine |
Protein Urine |
10.000,00 |
| 26 |
Urine |
PH |
10.000,00 |
| 27 |
Urine |
Urobilinogen |
10.000,00 |
| 28 |
Urine |
Bilurubin |
10.000,00 |
| 29 |
Urine |
Sedimen |
10.000,00 |
| 30 |
Urine |
Berat jenis |
10.000,00 |
| 31 |
Urine |
Urine Rutin/Urine lengkap |
25.000,00 |
| 32 |
Faeces |
Faeces Lengkap/Faeces Rutin |
20.000,00 |
| 33 |
Faeces |
Garam jenuh |
20.000,00 |
| 34 |
Faeces |
Benzidin test |
20.000,00 |
| 35 |
Faeces |
Telur cacing |
15.000,00 |
| 36 |
Serologi |
HBs Ag |
50.000,00 |
| 37 |
Serologi |
Anti HBs Ag |
60.000,00 |
| 38 |
Serologi |
Test kehamilan |
20.000,00 |
| 39 |
Serologi |
Golongan darah |
10.000,00 |
| 40 |
Serologi |
Golongan darah rhesus |
10.000,00 |
| 41 |
Serologi |
Toxsoplasma IgM |
192.500,00 |
| 42 |
Serologi |
Toxsoplasma IgG |
192.500,00 |
| 43 |
Serologi |
TPHA |
41.000,00 |
| 44 |
Serologi |
Widal |
40.000,00 |
| 45 |
Serologi |
VDRL |
30.000,00 |
| 46 |
Serologi |
T-3 |
210.000,00 |
| 47 |
Serologi |
T-4 |
210.000,00 |
| 48 |
Serologi |
DHF |
150.000,00 |
| 49 |
Serologi |
Asto |
51.000,00 |
| 50 |
Serologi |
RDT HIV |
150.000,00 |
| 51 |
Serologi |
Anti HBS AG kuantitatif |
190.000,00 |
| 52 |
Serologi |
Antibodi HIV kuantitatif |
246.000,00 |
| 53 |
Serologi |
HAV IGG IGM test |
95.000,00 |
| 54 |
Serologi |
HCV terst |
55.000,00 |
| 55 |
Serologi |
Anti HCV kuanitatif |
200.000,00 |
| 56 |
Serologi |
Covid antigen sars-cov2 |
99.000,00 |
| 57 |
Serologi |
PCR test covid-19 |
275.000,00 |
| 58 |
Serologi |
CRP |
45.000,00 |
| 59 |
Serologi |
RA |
30.000,00 |
| 60 |
Serologi |
RDT Leptospirosis |
40.000,00 |
| 61 |
Kimia Klinik |
HBs Ag |
50.000,00 |
| 62 |
Kimia Klinik |
Anti HBs Ag |
60.000,00 |
| 63 |
Kimia Klinik |
Test kehamilan |
20.000,00 |
| 64 |
Kimia Klinik |
Golongan darah |
10.000,00 |
| 65 |
Kimia Klinik |
Golongan darah rhesus |
10.000,00 |
| 66 |
Kimia Klinik |
Toxsoplasma IgM |
192.500,00 |
| 67 |
Kimia Klinik |
Toxsoplasma IgG |
192.500,00 |
| 68 |
Kimia Klinik |
TPHA |
41.000,00 |
| 69 |
Kimia Klinik |
Widal |
40.000,00 |
| 70 |
Kimia Klinik |
VDRL |
30.000,00 |
| 71 |
Kimia Klinik |
T-3 |
210.000,00 |
| 72 |
Kimia Klinik |
T-4 |
210.000,00 |
| 73 |
Kimia Klinik |
DHF |
150.000,00 |
| 74 |
Kimia Klinik |
Asto |
51.000,00 |
| 75 |
Kimia Klinik |
RDT HIV |
150.000,00 |
| 76 |
Kimia Klinik |
Anti HBS AG kuantitatif |
190.000,00 |
| 77 |
Kimia Klinik |
Antibodi HIV kuantitatif |
246.000,00 |
| 78 |
Kimia Klinik |
HAV IGG IGM test |
95.000,00 |
| 79 |
Kimia Klinik |
HCV terst |
55.000,00 |
| 80 |
Kimia Klinik |
Anti HCV kuanitatif |
200.000,00 |
| 81 |
Kimia Klinik |
Covid antigen sars-cov2 |
99.000,00 |
| 82 |
Kimia Klinik |
PCR test covid-19 |
275.000,00 |
| 83 |
Kimia Klinik |
CRP |
45.000,00 |
| 84 |
Kimia Klinik |
RA |
30.000,00 |
| 85 |
Kimia Klinik |
RDT Leptospirosis |
40.000,00 |
| 86 |
Narkoba |
Methampitamine |
35.000,00 |
| 87 |
Narkoba |
Morphine / Heroine |
35.000,00 |
| 88 |
Narkoba |
Ampethamine |
35.000,00 |
| 89 |
Narkoba |
Cannabinoids |
35.000,00 |
| 90 |
Narkoba |
Opiatest |
35.000,00 |
| 91 |
Narkoba |
Barbituratest |
35.000,00 |
| 92 |
Narkoba |
Benzoadiazepins |
35.000,00 |
*Berdasarkan Tarif Perda No.6 Tahun 2020
