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					                      Lab Price List                                                 Specialty Labs
                  Description                         Price                     Description                         Price

 Amylase                                          *    $8.00     Anemia Panel (Iron, Ferritin, RBC, TIBC)       *    $35.00
 ANA (anti-nuclear antibody)                      *   $25.00                                                    *
                                                                 Arthritis Profile (ANA, RF, Sed, Uric Acid, CRP)    $85.00
 B12 & Folate                                     *   $20.00     Food Sensitivity (IgG - US biotek) (96 foods)  *   $145.00
 Complete Blood Count (CBC) w/ Differential       *   $10.00     Glucose Panel (HCT,CRP,Insulin,Glucose,HgbA1C) *    $95.00
 Comprehensive Metabolic                          *   $10.00     Gluten Eval                                    *   $130.00
 DHEA Sulfate                                     *   $20.00     NMR Lipoprofile (Full-Spectrum Lipid Panel)    *    $80.00
 Estradiol                                        *   $20.00     Thyroid Panel #1 (TSH, Free T3, Free T4)       *    $36.00
 Ferritin                                         *   $12.00     Thyroid Panel #2 (TSH, Free T3, Free T4, TPO)  *    $50.00
 FSH (follicle-stimulating hormone)               *   $20.00
 Glucose                                          *    $8.00
 H.Pylorie Ab., IgG                               *   $22.00     Write in any other tests wanted: (Call with price questions)
 Hemoglobin A1-C                                  *   $15.00
 High Sensitivity CRP                             *   $19.00
 Iron                                             *   $10.00
 Lipid Panel                                      *   $10.00
 MMA (Methylmalonic Acid)                         *   $85.00
 Occult Blood Screen                              *   $20.00
 PSA, Free                                        *   $20.00
 PSA, Total (MCR Scr)                             *   $15.00
 Reverse T3                                       *   $23.00
 Sed Rate                                         *   $12.00
 T3, Free                                         *   $12.00     Would you like a consultation to decide what
 T4, Free                                         *   $12.00     labs you need?                               Yes / No
 T4 Total                                         *   $12.00
 T-Uptake                                         *   $16.00     Would you like a consultation to go over your
 Testosterone, Free &Total (includes SHBG)        *   $32.00     results?                                      Yes / No
 Thyroglobulin Abs                                *   $22.00
 Thyroid Peroxidase Abs (TPO)                     *   $15.00          * Consultations:    $30 (15 minutes)
 TSH (thyroid stimulating hormone)                *   $12.00                              $60 (15-30
 Vitamin D (25 OH)                                *   $42.00

 INSTRUCTIONS:                                                   PATIENT INFORMATION:
 1. Check labs requested.                                         Name:
 2. Fill out personal information.                                Phone:
 3. Fax or send Lab form to us (or call with info).               Address:
 4. We will take care of the rest!
                                                                  Date of Birth:
            ** Lab Draw Fee: $19.00

        Family Clinic of Natural Medicine                       Fax: (608)222-2771
4710 E. Broadway, Suite 190, Madison, WI 53716                 Phone: (608)222-2700                                 12-Apr
Write in any other tests wanted: (Call with price questions)

				
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posted:10/22/2012
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