In the previous reports, I had evaluated the costs of serial sterilization process, including collection of dirty-contaminated items, classification, check, washing, assembling, validation, packing, sterilization, picking, and transportation. As 12 years have passed since then, sterilization process costs were re-evaluated after the change of the duties system (suspension of primary on-site washing, transportation / supply, in-house third party operation, operation rooms, inpatient wards / outpatient sections). All data resources and intelligence related to sterilization process were collected. The resource included one-time operating costs of the sterilization device, average numbers of operating per month, average numbers of sterilized items, sterilization device use costs, validation costs, repair costs, machinery maintenance costs per month, washing costs, personnel expenses, and packing costs. These data led to costs per item of sterilization by autoclaving, ethylene oxide gas (EOG), and plasma with the use of hydrogen peroxide, according to various sizes of containers. As results, sterilization process costs per double-packed item were 57 yen by autoclaving, 177 yen by EOG, and 288 yen by plasma, respectively. Plasma sterilization process costs were higher than EOG sterilization, however, sterilization efficiency should be examined.