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    Glucose, Gestational, 1Hr
    2 X $22.00 = $44.00
    Follicle-stimulating Hormone (FSH) and Luteinizing Hormone (LH)
    2 X $45.00 = $90.00
    Complete Blood Count (CBC)
    1 X $20.00 = $20.00
    Prothrombin Time (PT) (INR)
    2 X $20.00 = $40.00
    Glucose, Fasting, Plasma
    2 X $21.00 = $42.00
    Hep B Core Ab, IgM
    2 X $44.00 = $88.00
    Hep A, B, C Ab Panel w/Reflex
    1 X $74.00 = $74.00
    Epstein Barr Evaluation (EBVCG, EBNAG, EDEAG, EBVCM)
    1 X $140.00 = $140.00
    Hep C Ab
    1 X $44.00 = $44.00
    Hep B Core Ab, Total w /Reflex to IgM
    1 X $44.00 = $44.00
    Epstein Barr Nuclear Ag ,IgG
    1 X $46.50 = $46.50
    Hep A Ab, IgM
    1 X $44.00 = $44.00
    Epstein Barr Viral Capsid Ag ,IgM
    1 X $46.50 = $46.50
    Immunoglobulin G (IgG Total)
    1 X $40.00 = $40.00
    Subtotal $803.00
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