| Row | Code Description
| Price(IRR) | Price(usd) |
1
| Abdominoplasty
| 234,000,000
| $371.4 |
2
| Appendectomy (Laparoscopy) | 195,519,440 | $310.3 |
| 3 | appendectomy (surgery) | 140,000,000 | $222.2 |
| 4 | Nasal endoscopy, surgery; By controlling nosebleeds | 50,000,000 | $79.3 |
| 5 | Removing screws and plates | 147,489,063 | $234.1 |
| 6 | Joint replacement | 301,973,750 | $479.3 |
| 7 | fat mass | 65,000,000 | $103.1 |
| 8 | Thyroidectomy | 61,978,800 | $98.3 |
| 9 | IUD removal | 40,497,813 | $64.2 |
| 10 | Natural childbirth | 12,686,000 | $238 |
| 11 | cystectomy
| 161,144,880 | $255.7 |
| 12 | Cystoscopy
| 89,050,000 | $141.3 |
| 13 | Cystoscopy and ductal dilatation | 84,500,000 | $134.1 |
| 14 | Pilonidal sinus | 106860000 | $169.6 |
15
| broken nose | 103298000 | $163.9 |
16
| Cesarean section | 188786000 | $299.6 |
17
| Phototherapy | 53430000 | $84.8 |
18
| Curtage | 90860000 | $144.2 |
19
| Diagnostic curettage | 60000000 | $95.2 |
20
| mastectomy | 190982500 | $303.1 |
21
| nephrectomy | 350000000 | $555.5 |
22
| Bilateral inguinal hernia | 194685563 | $309.02 |
23
| Unilateral inguinal hernia | 100000000 | $158.7 |
24
| Abdominal hernia (incisional) | 175000000 | $277.7 |
25
| Umbilical hernia | 230000000 | $365.07 |
26
| hemorrhoids | 97955000 | $155.4 |
27
| Hymenectomy | 47196500 | $74.9 |
28
| Hydrocele | 89050000 | $141.3 |
29
| hysterectomy | 242150000 | $384.3 |
30
| Bilateral varicocele | 120000000 | $190.4 |
31
| Unilateral varicocele | 106860000 | $169.6 |
32
| Varicocele + bilateral hernia | 220310960 | $349.6 |
33
| Double room every night
| 43678400 | $69.3 |
34
| Triple room every night
| 30342400 | $48.1 |
35
| Cost of ICU (special care) bed per night | 118043200 | $187.3 |
36
| The cost of a healthy baby bed per night | 26846400 | $42.6 |
37
| Emergency bed fee (less than 6 hours of hospitalization) | 19171200 | $30.4 |
| 38 | Excision of pilonidal cyst or sinus, simple, extensive or mesh | 270000000 | $270 |
| 39 | Incision and drainage of appendiceal abscess or peritonitis | 450000000 | $450 |
| 40 | Inguinal hernia repair, sliding | 330000000 | $330 |
| 41 | Varicocele excision or ligation of the spermatic veins | 280000000 | $280 |
| 42 | Colporrhaphy (compartment repair) anterior-posterior | 570000000 | $570 |
| 43 | Dilation and curettage, diagnostic or therapeutic, non-obstetric | 220000000 | $220 |
| 44 | Routine obstetric care, including prenatal and postpartum care, vaginal delivery (with or without episiotomy) | 400000000 | $400 |
| 45 | Routine obstetric care, including antenatal care, cesarean delivery | 650000000 | $650 |
| 46 | Performing cataract surgery with lens implantation; by any method | 420000000 | $420 |
| 47 | Nasolacrimal duct aspiration, with or without irrigation | 170000000 | $170 |
| 48 | Plastic repair of the vulva (such as labiaplasty) | 150000000 | $150 |
| 49 | Incomplete mastectomy for gynecomastia or mastectomy | 260000000 | $260 |
| 50 | Treatment of incomplete abortion; in any trimester, with surgery | 170000000 | $170 |