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    Testosterone, Total
    1 X $30.00 = $30.00
    SS-B (La) Abs
    1 X $35.50 = $35.50
    Sm/RNP Abs
    1 X $51.50 = $51.50
    Sm (Smith) Abs
    1 X $48.00 = $48.00
    Herpes I & II IgG
    1 X $65.00 = $65.00
    Complement C4
    1 X $32.50 = $32.50
    Subtotal $262.50
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