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    PSA, Total (mcr Scr)
    1 X $25.00 = $25.00
    STD Panel
    1 X $84.00 = $84.00
    Deamidated Gliadin Peptide IgA
    1 X $41.50 = $41.50
    Glucose
    1 X $20.00 = $20.00
    Renal Function Panel
    1 X $20.00 = $20.00
    Lipase
    1 X $20.00 = $20.00
    Subtotal $210.50
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