Revised Suyog Hospital A unit of Suyog Multispeciality Solutions LLP(ANH),

17/Jun/2025
Indore, Madhya Pradesh, Hos-85297

Star Package Rates

Maximum
[Link] Procedure Name Duration of
Deluxe/Single Sharing Occupancy/
Stay General ward
Room AC Single Room Non AC

E.N.T

Mastoidectomy + Tympanoplasty
1 3 42,000 35,500 29,500
- Including Meatoplasty + Ossciculoplasty + Canaloplasty

2 FESS Unilateral 2 25,000 21,000 17,500

3 FESS Bilateral 2 33,000 28,000 23,000

FESS + Septoplasty with turbinectomy or polypectomy / conchoplasty

4 3 30,000 25,500 21,000
- Unilateral

FESS + Septoplasty with turbinectomy or Polypectomy / Conchoplasty

5 3 38,000 32,500 26,500
- Bilateral

Tympanoplasty
6 2 21,500 18,000 15,000
- All Types of Tympanoplasty Including Canaloplasty

Tonsillectomy
7 2 24,000 20,500 17,000
- Including Coblation Wand & LASER charges

Tonsillectomy & Adenoidectomy

8 3 30,000 25,500 21,000
- Including Coblation Wand & LASER charges

Adenoidectomy
9 2 24,000 20,500 17,000
- Including Coblation Wand & LASER charges

10 Microlaryngeal excision of Nodule / Polyp / Cysts 1 30,000 25,500 21,000

11 Myringotomy with grommet insertion 2 22,000 18,500 15,500

12 Stapedectomy 2 34,000 29,000 24,000

13 Septoplasty 2 25,000 21,000 17,500

14 Septoplasty with Turbinoplasty - Bilateral Turbinates 2 30,000 25,500 21,000

15 Dacryocystorhinostomy (DCR) 0 15,000 15,000 15,000

16 Removal of Submandibular Salivary gland 4 35,000 29,500 24,500

17 Superficial parotidectomy 4 40,000 34,000 28,000

18 Total Parotidectomy 4 55,000 46,500 38,500

19 Thyroglossal Cyst - Excision 3 35,000 29,500 24,500

20 Thyroglossal Fistula - Excision 3 35,000 29,500 24,500

GENERAL SURGERY

21 Open - Appendicectomy (Pediatric / Adult) 5 38,000 32,500 26,500

22 Laparoscopic - Appendicectomy (Pediatric / Adult) 5 42,000 35,500 29,500

23 Open - Cholecystectomy (Pediatric / Adult) 5 40,000 34,000 28,000

24 Laparoscopic - Cholecystectomy (Pediatric / Adult) 5 45,000 38,000 31,500

25 Circumcision (Day Care) 0 12,000 12,000 12,000

26 Fissurectomy with Sphincterotomy 4 27,000 23,000 19,000

27 Fistulectomy - Low (Including cost of Laser) with Sphincterotomy 4 23,000 19,500 16,000

Page 1 of 7
 Revised Suyog Hospital A unit of Suyog Multispeciality Solutions LLP(ANH),
17/Jun/2025
Indore, Madhya Pradesh, Hos-85297

Star Package Rates

Maximum
[Link] Procedure Name Duration of
Deluxe/Single Sharing Occupancy/
Stay General ward
Room AC Single Room Non AC

28 Fistulectomy - High (Including cost of Laser) with Sphincterotomy 4 30,000 25,500 21,000

Haemorrhoidectomy - (Stapler / Routine)

29 4 26,000 22,000 18,000
- Excluding Cost of Stapler
Haemorrhoidectomy + Fissurectomy with Sphincterotomy
30 4 31,000 26,500 21,500
- Excluding cost of Staples and Tackers

31 Herniorraphy - Inguinal 4 33,000 28,000 23,000

Hernioplasty - Inguinal/Femoral - Unilateral

32 4 33,000 28,000 23,000
- Excluding Cost of Mesh

Hernioplasty - Inguinal/Femoral - Bilateral

33 4 44,000 37,500 31,000
- Excluding Cost of Mesh

Hernioplasty - Umblical/Paraumblical
34 4 37,000 31,500 26,000
- Excluding Cost of Mesh

Hernioplasty - Incisional/ Ventral

35 4 40,000 36,000 32,000
- Excluding Cost of Mesh

Laparoscopic Hernioplasty - Inguinal - Unilateral

36 3 40,000 36,000 32,000
- Excluding Cost of Mesh & Tackers

Laparoscopic Hernioplasty - Inguinal - Bilateral

37 3 50,000 45,000 40,000
- Excluding Cost of Mesh & Tackers

Laparoscopic Hernioplasty - Umblical/Paraumblical

38 3 40,000 36,000 32,000
- Excluding Cost of Mesh & Tackers

Laparoscopic Hernioplasty - Incisional/Ventral

39 3 45,000 40,500 36,000
- Excluding Cost of Mesh & Tackers

40 Right or Left Hemicolectomy 10 65,000 55,000 45,500

41 Lymph Node Biopsy (Cervical / Axillary / Inguinal)- Under GA 3 16,000 13,500 11,000

42 Lipoma - Under GA 3 16,000 13,500 11,000

43 Perianal Abcess (I&D) 3 22,000 18,500 15,500

44 Pilonidal Sinus with primary closure 3 22,000 18,500 15,500

45 Pilonidal Sinus with flap cover 3 28,000 24,000 19,500

46 Modified Radical Mastectomy 7 55,000 46,500 38,500

47 Lumpectomy with Node dissection 7 50,000 42,500 35,000

48 BCS with Oncoplasty with Node dissection 7 60,000 51,000 42,000

49 Simple Mastectomy 5 44,000 37,500 31,000

50 Breast Lumpectomy 3 26,000 22,000 18,000

51 Thyroidectomy - any type 7 55,000 46,500 38,500

Surgery for varicose veins saphenofemoral ligation and stripping /

52 7 38,000 32,500 26,500
sclerotherapy - Unilateral
Varicose veins - Radiofrequency ablation, endovenous laser treatment
53 5 48,000 41,000 33,500
- Including Cost of Laser and Catheter

54 Wound debridement - Minor 3 10,000 8,500 7,000

Page 2 of 7
 Revised Suyog Hospital A unit of Suyog Multispeciality Solutions LLP(ANH),
17/Jun/2025
Indore, Madhya Pradesh, Hos-85297

Star Package Rates

Maximum
[Link] Procedure Name Duration of
Deluxe/Single Sharing Occupancy/
Stay General ward
Room AC Single Room Non AC

55 Wound debridement - Major 3 14,000 12,000 10,000

56 Excision of Ganglions 1 12,000 10,000 8,500

57 Colonoscopy 0 3,500 3,500 3,500

58 ERCP - EPT / Stenting / Stone Removal 0 15,000 15,000 15,000

59 OGD scopy 0 2,000 2,000 2,000

60 Sigmoidoscopy 0 2,000 2,000 2,000

OBSTETRICS & GYNECOLOGY

Hysterectomy - Abdominal
61 7 48,000 41,000 33,500
- With or Without BSO and adhesiolysis
Laparoscopic Hysterectomy - Abdominal
62 7 55,000 46,500 38,500
- With or Without BSO and adhesiolysis
Hysterectomy - Vaginal
63 7 46,000 39,000 32,000
- With or Without Pelvic Floor Repair and adhesiolysis
Hysterectomy - LAVH
64 7 50,000 42,500 35,000
- With or Without Pelvic Floor Repair and adhesiolysis

65 D & C with Hysteroscopy (Day Care) 0 10,000 10,000 10,000

66 Open - Ruptured Ectopic Pregnancy 5 38,000 32,500 26,500

67 Laparoscopic - Ruptured Ectopic Pregnancy 5 44,000 37,500 31,000

68 Open - Wertheims with Node dissection 9 70,000 59,500 49,000

69 Laparoscopic - Wertheims with Node dissection 9 80,000 68,000 56,000

70 Open - Myomectomy 7 40,000 34,000 28,000

71 Laparoscopic - Myomectomy 7 45,000 38,000 31,500

72 Ovarian Cystectomy - Open 3 35,000 29,500 24,500

73 Ovarian Cystectomy - Laparoscopic 3 38,000 32,500 26,500

74 Normal Delivery with Well Baby Care (Single / Twins) 3 25,000 22,000 20,000

75 LSCS with Well Baby Care (Single / Twins) 5 45,000 38,000 34,000

76 Bartholin cyst removal 0 10,000 10,000 10,000

ORTHOPAEDICS

ACL / PCL / MCL Reconstruction

77 5 52,000 44,000 36,500
- Excluding Cost of Implant

Menisectomy / meniscus repair / meniscus root repair / Meniscus

78 5 40,000 34,000 28,000
balancing

79 Carpal Tunnel Release (U/L) 3 21,000 18,000 14,500

80 Closed Reduction-Dislocation - Minor 3 10,000 8,500 7,000

81 Closed Reduction-Dislocation - Major 3 16,000 13,500 11,000

Page 3 of 7
 Revised Suyog Hospital A unit of Suyog Multispeciality Solutions LLP(ANH),
17/Jun/2025
Indore, Madhya Pradesh, Hos-85297

Star Package Rates

Maximum
[Link] Procedure Name Duration of
Deluxe/Single Sharing Occupancy/
Stay General ward
Room AC Single Room Non AC

82 Implant Removal - Minor (Except K-Wire) 1 14,000 12,000 10,000

83 Implant Removal - Major 3 26,000 22,000 18,000

84 K Wire Removal 0 1,700 1,700 1,700

85 Open Reduction - Dislocation - Minor 4 26,000 22,000 18,000

86 Open Reduction - Dislocation - Major 5 33,000 28,000 23,000

87 ORIF of Fracture - K Wire - Including Cost of Implant 2 13,500 11,500 9,500

88 ORIF of Fracture - Plating - Excluding Cost of Implant 7 40,000 34,000 28,000

89 Acetabular Fracture - Posterior - Wall / Column - ORIF 5 50,000 42,500 35,000

90 Acetabular Fracture - Anterior - Wall / Column - ORIF 5 45,000 38,000 31,500

91 ORIF - Ankle/Talus/Calcaeneum - Excluding cost of Implant 5 42,000 38,000 33,500

92 ORIF-Trimalleolar 5 45,000 38,000 31,500

93 ORIF-Bimalleolar 5 40,000 34,000 28,000

94 IM Nailing - Interlocking - Excluding Cost of Implant 7 48,000 41,000 33,500

Fracture Neck of Femur (NOF) / Intertrochantric / Subtrochantric

95 7 52,000 44,000 36,500
- Excluding Cost of Implant

96 Discectomy with Laminectomy 7 60,000 51,000 42,000

97 Microdiscectomy 5 70,000 59,500 49,000

Spinal Fusion (Cervical) - Where Implant is not going to be used

98 7 70,000 59,500 49,000
- Including Navigation
Spinal Fusion ( Lumbar / Thoracic)
99 7 70,000 59,500 49,000
- Where Implant is not going to be used- Including Navigation
Spinal Fusion (Cervical) - Where Implant is going to be used
100 7 78,000 66,500 54,500
- Including Navigation - Excluding Implant
Spinal Fusion (Lumbar / Thoracic) - Where Implant is going to be used
101 7 78,000 66,500 54,500
- Including Navigation - Excluding Implant

102 Closed Reduction of Fracture Under GA for Major Joints 4 11,500 9,500 8,000

Bipolar Hemiarthroplasty / Dynamic hip screw (DHS)

103 7 52,000 44,000 36,500
- Excluding Cost of Implant
Total Knee Replacement - Unilateral - Including Navigation
104 7 80,000 68,000 56,000
- (Excluding Cost of Implant)
Total Knee Replacement - Bilateral - Including Navigation
105 10 130,000 110,500 91,000
- (Excluding Cost of Implant)
Total Hip Replacement - Unilateral - Including Navigation
106 7 80,000 68,000 56,000
- (Excluding Cost of Implant)
Total Hip Replacement - Bilateral - Including Navigation
107 10 130,000 110,500 91,000
- (Excluding Cost of Implant)

108 Shoulder Arthoscopy - Bankart Repair 4 45,000 38,000 31,500

109 Shoulder Arthoscopy - Bankart & Hill Sachs Lesion 4 50,000 42,500 35,000

Page 4 of 7
 Revised Suyog Hospital A unit of Suyog Multispeciality Solutions LLP(ANH),
17/Jun/2025
Indore, Madhya Pradesh, Hos-85297

Star Package Rates

Maximum
[Link] Procedure Name Duration of
Deluxe/Single Sharing Occupancy/
Stay General ward
Room AC Single Room Non AC

110 Shoulder Open - Latarjet / Bone Block 4 45,000 38,000 31,500

111 Shoulder Open - Rotator Cuff Repair 4 45,000 38,000 31,500

112 Shoulder Arthoscopy - Rotator Cuff Repair 4 45,000 38,000 31,500

113 Shoulder Arthoscopy - Cuff Repair with Anchors 4 45,000 38,000 31,500

114 Shoulder Arthoscopy - Sub-Acrominal Decompression 4 40,000 34,000 28,000

115 Fixation of Fracture of Mandible / Maxilla 4 30,000 25,500 21,000

116 Reduction of compound Fractures with external fixation 3 25,000 21,000 17,500

UROLOGY & NEPHROLOGY

117 A V Fistula For Dialysis (Day Care) 0 17,000 17,000 17,000

118 TURP 5 44,000 37,500 31,000

119 HoLEP - Including cost of Laser 3 55,000 46,500 38,500

120 Hydrocelectomy Unilateral 3 20,000 17,000 14,000

121 Hydrocelectomy Bilateral 3 25,000 21,000 17,500

122 Varicocelectomy 3 21,000 18,000 14,500

123 PCNL + Stenting 2 42,000 35,500 29,500

124 Mini - Perc + Stenting 2 45,000 38,000 31,500

125 RIRS 2 55,000 46,500 38,500

126 Cystoscopy + URS lithotripsy - Including Cost of DJ Stenting and LASER 2 40,000 34,000 28,000

127 Lithotripsy - ESWL + Stenting - For 3 Sittings 0 22,000 18,500 15,500

128 Hemo-Dialysis Per sitting - Including cost of Dialyser 0 1,400 1,400 1,400

129 Cystoscopy & DJ Stent Insertion (Day care) 0 14,000 14,000 14,000

130 Cystoscopy & DJ Stent Removal (Day care) 0 10,000 10,000 10,000

131 TURBT 5 50,000 42,500 35,000

132 Orchidectomy - Unilateral 3 25,000 21,000 17,500

133 Orchidectomy - Bilateral 3 33,000 28,000 23,000

134 Pyeloplasty Open Unilateral 3 50,000 42,500 35,000

135 Pyeloplasty Open Bilateral 3 55,000 46,500 38,500

136 Pyeloplasty Lap Unilateral 3 55,000 46,500 38,500

137 Pyeloplasty Lap Bilateral 3 60,000 51,000 42,000

138 Bipolar TURP / TURIS / Plasma Vaporization 4 40,000 34,000 28,000

Page 5 of 7
 Revised Suyog Hospital A unit of Suyog Multispeciality Solutions LLP(ANH),
17/Jun/2025
Indore, Madhya Pradesh, Hos-85297

Star Package Rates

Maximum
[Link] Procedure Name Duration of
Deluxe/Single Sharing Occupancy/
Stay General ward
Room AC Single Room Non AC

139 Surgery for Staghorn Calculus 3 45,000 38,000 31,500

140 Surgery for Nephrolithtomy & Pylolithotomy 3 45,000 38,000 31,500

141 UV Fistula / VVF Repair 3 50,000 42,500 35,000

142 Optical Internal Urethrotomy (OIU)/ Visual Internal Urethrotomy (VIU) 3 15,000 12,500 10,500

143 Urethroplasty - Benign Monoclonal Gammopathy (BMG) 3 80,000 68,000 56,000

144 Urethroplasty 3 45,000 38,000 31,500

145 Operation for Torsion of Testis 3 50,000 42,500 35,000

146 Meatotomy (Day care) 0 10,000 10,000 10,000

CARDIOLOGY

147 ASD Surgical Closure -Open 7 85,000 72,000 59,500

148 VSD Surgical Closure - Open 7 85,000 72,000 59,500

149 ASD / VSD Device Closure - Excluding Cost of Device 5 62,000 52,500 43,500

150 CABG (On / Off Pump) 10 150,000 127,500 105,000

151 Coronary Angiogram - Including Cost of dye 0 10,000 10,000 10,000

Angioplasty - PTCA
152 - (Including dye, 1-Balloon, 1-Catheter & 1-Guidewire) 5 70,000 59,500 49,000
- Excluding cost of Stent

Angiography with Angioplasty

153 - (Including dye, 1-Balloon, 1-Catheter & 1-Guidewire) 5 80,000 68,000 56,000
- Excluding cost of Stent

Single Valve Replacement

154 10 155,000 131,500 108,500
- Excluding Cost of Valve

Double Valve Replacement

155 10 165,000 140,000 115,500
- Excluding Cost of 2 Valves

Permanent Pacemaker Implantation (PPI)

156 5 50,000 42,500 35,000
- Excluding Cost of Pacemaker

Temporary Pacemaker Implantation (TPI)

157 2 14,000 12,000 10,000
- Excluding Cost of Pacemaker

158 EPS & RF Ablation (Cost of Procedure Only) 3 60,000 51,000 42,000

OPHTHALMOLOGY

159 Cataract - Phaco with Unifocal Lens - Excluding Cost of Lens 0 10,000 10,000 10,000

160 Cataract - MICS with Unifocal Lens - Excluding Cost of Lens 0 12,000 12,000 12,000

161 Cataract - Phaco with Multifocal / Toric - Excluding cost of Lens 0 12,000 12,000 12,000

162 Cataract - MICS with Multifocal / Toric - Excluding cost of Lens 0 14,000 14,000 14,000

163 DCR 0 15,000 15,000 15,000

Page 6 of 7
 Revised Suyog Hospital A unit of Suyog Multispeciality Solutions LLP(ANH),
17/Jun/2025
Indore, Madhya Pradesh, Hos-85297

Star Package Rates

Maximum
[Link] Procedure Name Duration of
Deluxe/Single Sharing Occupancy/
Stay General ward
Room AC Single Room Non AC

164 Vitrectomy 0 18,000 18,000 18,000

165 Pterygium With Conjunctival Autograft 0 10,000 10,000 10,000

Note Forming Part of Agreement

A. General Clauses:-
1. Package Charges Inclusive of Implants:
a) When the procedure charges include implants (such as mesh, prosthetics, etc.), the package price represents the maximum payable amount for the entire treatment (end-to-end). This
includes: Room rent, Nursing care, Operating theatre charges, Doctor's/Surgeon's fees, Assistant Surgeon fees, Anesthetist fees, Necessary investigations, Blood and blood products, Medications
and consumables for the specified hospital stay duration, Implants/Mesh/Prostheses (where applicable).
2. Items in SOC that are part of other services and should not be billed separately :
a) Admission Charges, Medical Evaluation, Medical History assessment, MLC charges, Drug Handling Charges, Infection Control Charges, Misc common items, injection administration charges
cannot be charged separately since these items are subsumed under Room rent, nursing charges.
b) Catheter / Line / Drain Removal by nursing, Catheterization Charges, Dressing Charges, B.P Check up, Blood Pressure Screening, IV Infusion Charges, IV Cannulation, EMO fee,
Lactation and Breastfeeding Consultant should not be billed separately since these items are subsumed under nursing, doctor fees.
3. Package Charges for Procedure + Implant Cost:
a) Package Charges: Similar to point 1, the package price reflects the maximum payable amount for the entire treatment, including the items mentioned above (room rent, nursing, etc.).
b) Cost of Implants: The actual cost of mesh, implants, and prostheses will be separate and payable based on current market rates. Note: This applies only to implants not regulated by the
National Pharmaceutical Pricing Authority (NPPA) and the Drugs Price Control Order (DPCO).
c) NPPA Regulated Implants: Cardiac stents, knee implants, and any other future products regulated by the NPPA will be charged according to their NPPA guidelines.
d) All pharmaceutical products will be payable as per the Drug Price Control Order (DPCO) guidelines & MRP (Drugs administered to patient should be the same as billed) including the brand of
the manufacturer.
e) Imported Drugs: If imported drugs are used, the payable amount will be equivalent to the cost of the Indian alternative drug or as per the DPCO capping.
f) If the Patient develops complications during hospitalization, the agreed upon package price may be revised to reflect the additional costs incurred. The Hospital must submit sufficient
documentation evidencing such complications and justifiable reasons for the increased cost.
4. The service provider must provide a specification, invoice and sticker of the implant/mesh/prosthesis used, whenever applicable. However the actual will be paid based on the Prevailing
Market Price.
5. In Case the Insured Opts for a room category exceeding their policy eligibility the service Provider shall collect only the difference in room rent from the insured patient.
6. The Agreed packages will be applicable for all Star Health Patients, In both Cashless and Reimbursement claims.

[Link] Guidelines on Surgical procedures:-

a) If more than one surgical procedure is involved in the same sitting by the same surgical team and the subsequent procedures are at different sites and expected to consume considerable time
to the operating team, then the charges payable are as per the following scale:-
I. 100% of package rates for first surgery.
II. For the second surgery, upto 50% of package rates applicable to that procedure.
III. Subsequent procedures,upto 25% of the applicable package rates for respective procedures.
b) If more than one surgical procedure is involved in the same sitting and at the same site by the same surgical team and expected to consume considerable time to the operating team, then the
charges payable are as per the following scale:-
I. 100% of package rates for first surgery.
II. For subsequent surgeries, up to 25% of applicable package rates for respective procedures.
c) Adhesiolysis when combined with another procedure, the charges for the same is payable up to 15% of the charges admissible for the main procedure provided such adhesions lead to Sub
acute intestinal obstruction [SAIO] / or is Dense & extensive and supported by OT notes / intra-op pictures/CD.
d) Assistant Surgeon/Associate Surgeon will not be payable for bottom Surgeries (Anal and Perianal), ENT Surgeries, Gynecology surgeries like Dilatation and curettage, Urology surgeries like DJ
stent Removal as the services of Assistant surgeon/Associate Surgeon is generally considered as not required.
e) Exploratory Laparotomy / Thoracotomy / Arthroscopy / Laparoscopy / Hysteroscopy / Endoscopy / Cystoscopy etc. will not be paid separately, if it is followed by a Surgery/Procedure, say
I. In case of Laparoscopic Appendicectomy procedure, diagnostic laparoscopy will not be payable separately as it forms part of the procedure.
II. In case of TURP procedure, Cystoscopy will not be payable separately as it forms part of the procedure and the like.
f) Nerve exploration / Neurolysis / reduction of dislocation or fracture, during fracture fixation is not payable separately
g) Histopathology reports [wherever applicable] are mandatory at settlement.
h) Radiology reports must contain Radiologist signature.
7. Cashless authorization will be as per the Terms and Conditions and Limitations of the policy of insurance, including Sub-limits and Co-pay.
8. This Agreed Package Rates is valid for a period of 3 years from the date of acceptance by both the parties.
9. The Service Provider shall strictly adhere to all the terms and conditions outlined in the MOU, as well as the agreed-upon package charges, without imposing additional fees on either Star
Health Insurance Company or its customers. Failure to comply may result in Star Health exercising its right to claw back payments from the hospital.

For - Hospital Name

Authorized Seal & Signatory

Date:

Page 7 of 7