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    PSA, Total (mcr Scr)
    1 X $25.00 = $25.00
    Vitamin B12 & Folate
    2 X $30.00 = $60.00
    Troponin-I
    1 X $44.00 = $44.00
    MMRV Evaluation (MSL, MUMP, RUB, VZ)
    1 X $95.00 = $95.00
    Pre-Albumin
    1 X $72.50 = $72.50
    Mono Test (Epstein Barr Heterophile Ag IgM)
    1 X $32.50 = $32.50
    Electrolyte Panel
    1 X $18.00 = $18.00
    Insulin, Fasting
    1 X $30.00 = $30.00
    Glucose
    2 X $20.00 = $40.00
    Follicle-Stimulating Hormone (FSH)
    1 X $30.00 = $30.00
    Pregnancy Test, Serum (Positive or Negative)
    1 X $29.00 = $29.00
    Glucose, Fasting, Plasma
    1 X $21.00 = $21.00
    Hep A, B, C Ab Panel w/Reflex
    1 X $74.00 = $74.00
    Pregnancy Test, Serum (Quantitative)
    1 X $30.00 = $30.00
    Folate
    1 X $23.00 = $23.00
    Growth Hormone
    1 X $49.00 = $49.00
    Chloride
    1 X $18.00 = $18.00
    Free Thyroxine Index
    1 X $45.00 = $45.00
    Cholesterol, Total
    1 X $19.00 = $19.00
    Estrogens, Total
    1 X $65.00 = $65.00
    Subtotal $820.00
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