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    Prothrombin Time (PT) (INR)
    1 X $20.00 = $20.00
    Hep B Surface Ag w/Con
    1 X $55.00 = $55.00
    Partial Thromboplastin Time (PTT), Activated
    1 X $19.50 = $19.50
    MMRV Evaluation (MSL, MUMP, RUB, VZ)
    1 X $95.00 = $95.00
    Potassium, Plasma
    1 X $21.50 = $21.50
    Platelet Count
    1 X $18.50 = $18.50
    DHEA-Sulfate
    1 X $30.00 = $30.00
    Tri-iodothyronine T3 Total
    1 X $30.00 = $30.00
    Electrolyte Panel
    1 X $18.00 = $18.00
    SS-B (La) Abs
    1 X $35.50 = $35.50
    Tri-iodothyronine Free T3
    1 X $30.00 = $30.00
    Subtotal $373.00
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