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    Bilirubin, Direct
    1 X $19.00 = $19.00
    Deamidated Gliadin Peptide IgG
    1 X $41.50 = $41.50
    PSA Free and Total
    1 X $40.00 = $40.00
    Fructosamine
    1 X $29.00 = $29.00
    Prothrombin Time (PT) (INR)
    1 X $20.00 = $20.00
    Subtotal $149.50
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