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    Chloride
    1 X $18.00 = $18.00
    Hemoglobin A1C
    1 X $26.00 = $26.00
    Cholesterol, Total
    1 X $19.00 = $19.00
    Rubella IgM
    1 X $44.50 = $44.50
    Electrolyte Panel
    1 X $18.00 = $18.00
    Fibrinogen
    1 X $34.00 = $34.00
    Free Thyroxine Index
    1 X $45.00 = $45.00
    Growth Hormone
    1 X $49.00 = $49.00
    Subtotal $253.50
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