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    Partial Thromboplastin Time (PTT), Activated
    1 X $19.50 = $19.50
    Reverse T3
    4 X $54.00 = $216.00
    Immunoglobulins G, A, M
    1 X $65.50 = $65.50
    Cytomegalovirus, IgM
    1 X $49.00 = $49.00
    PSA Free and Total
    2 X $40.00 = $80.00
    HIV 5th Generation (Ag-Ab Screen, HIV1-Ab, HIV1-Ag, HIV2-Ab)
    1 X $48.00 = $48.00
    Subtotal $478.00
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