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    Epstein Barr Early Ag, IgG
    1 X $46.50 = $46.50
    Tissue Transglutaminase IgG
    1 X $41.50 = $41.50
    Cytomegalovirus, IgM
    2 X $49.00 = $98.00
    Thyroxine Free (FT4)
    1 X $30.00 = $30.00
    Prothrombin Time (PT) (INR)
    1 X $20.00 = $20.00
    Protein, Total
    1 X $18.50 = $18.50
    Tri-iodothyronine Free T3
    1 X $30.00 = $30.00
    Subtotal $284.50
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