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    Bilirubin, Direct
    1 X $19.00 = $19.00
    Lipid Panel
    1 X $24.00 = $24.00
    Glucose
    1 X $20.00 = $20.00
    Deamidated Gliadin Peptide IgA
    1 X $41.50 = $41.50
    Chromatin
    1 X $91.00 = $91.00
    Prostatic Acid Phosphate
    1 X $60.00 = $60.00
    Subtotal $255.50
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