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    Potassium, Plasma
    1 X $21.50 = $21.50
    11 ANA Components (no ANA Screen)
    1 X $214.00 = $214.00
    Sm (Smith) Abs
    1 X $48.00 = $48.00
    Tri-iodothyronine T3 Total
    1 X $30.00 = $30.00
    Quantiferon TB Gold Plus 4th Gen
    1 X $112.50 = $112.50
    Hep B Surface Ag w/Con
    1 X $55.00 = $55.00
    Human Chorionic Gonadotropin HCG (Testicular Tumor)
    1 X $27.00 = $27.00
    Saliva Hormone Female Evaluator Plus (11 Days)
    1 X $394.00 = $394.00
    Arthritis Panel
    1 X $90.00 = $90.00
    Prothrombin Time (PT) (INR)
    1 X $20.00 = $20.00
    Epstein Barr Evaluation (EBVCG, EBNAG, EDEAG, EBVCM)
    1 X $140.00 = $140.00
    Hep A Ab, IgM
    1 X $44.00 = $44.00
    Culture, Mycobacteria (AFB)
    1 X $48.00 = $48.00
    Subtotal $1,244.00
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