Test Lab Order

Name*
First
Date
DIAGNOSIS
- Allergic Rhinitis J305
- Other Asthma J45998
- Dermatitis due to ingested food L272
- Rash and other nonspecific skin eruption R21
- Nutritional Deficiency
- IBS/Diarrhea
- IBS/No Diarrhea
- Abdominal Pain
- Constipation
- Diarrhea
- Gas
- GERD
QUESTS TESTING
- Draw FEE ($10)
- 1st panel with candida ($255)
- 1st panel NO candida ($210)
- RETEST2* ($100)
- Out of State FEE ($25)
- *Bilirubin, Direct ($7) 285
- *CBC ($6) 6399
- *Comprehensive Metabolic Panel ($8) 10231
- *Hs-CRP ($14) 10124
- *Hemoglobin A1c with eAG ($8) 16802
- *Insulin ($9) 561
- *Lipid Panel ($10) 7600
- *Phosphate (as Phosphorus) ($5) 718
- *25-Hydroxyvitamin D, LC/MS/MS ($19) 17306
- *Thyroid Panel with TSH ($14) 7444
- ___________________________
- ___________________________
- T3, Free (FT3) ($10) 34429
- TPO and TGB ($23) 7260
- ANA, w/titer ($25) 249
- Candida Antibodies IGG, IGM, IGA ($45) 30440
- Creatine Kinase ($5) 374
- Ferritin ($5) 457
- Iron, Total and TIBC ($5) 7573
- Gamma Glutamyl Transferase (GGT) ($5) 482
- Homocysteine ($18) 31789
- Lactate Dehydrogenase (LD) ($3) 593
- Magnesium ($4) 622
- Rheumatoid Factor ($5) 4418
- Uric Acid ($4) 905
Heart and Artery Health
- Cardio IQ Lp Frac., Ion Mobility ($50) 91604
- Cardio IQ Lipoprotein (a) ($20) 91729
- Cardio IQ Apolipoprotein B ($30) 91726
- Cardio IQ Omega 3 and 6 Fatty Acids ($69) 91734
- CO-Q10 ($50) 19826
- CK isoenzymes w/total ($25) 4451
- LP-PLA2 (Inf. of arteries and Alzheimer’s) ($30) 91738
- NT-proBNP ($110) 11188
GENETIC TESTING
- Genetic Testing - Health, Traits and Ancestry ($200)
- Genetic Testing - Ancestry Only ($100)
- Genetic Reporting and Analysis ($100)
Digestive/Immune Testing
- Alletess 15 IgE & IgG Mold Testing ($275)
- Alletess 25 IgE & 96 ($300)
- Alletess 25 IgE & 184 ($410)
- Alletess 96 IgG ($135)
- Alletess 96 IgG Finger Prick ($135)
- Alletess 184 IgG ($245)
- Alletess 184 IgG Finger Prick ($245)
- Cyrex Multiple Autoantibodies ($700)
- Cyrex Intestinal Permeability ($340)
- Diagnostic Solutions GI- MAP ($375)
- Diagnostic Solutions GI- MAP ($189)
- Dunwoody Adv. Intestinal Barrier Assessment ($330)
- Elissa/Act Enhanced Panel ($360)144
- Elissa/Act Enhanced Panel ($490) 212
- Genova Small Intestinal Bacterial Overgrowth ($230)
- Vibrant America 96 IGE Foods ($365)
- Vibrant America 96 IGE Foods Insurance ($70)
Neurotransmitter and Hormones
- DUTCH Adrenal Panel ($200)
- DUTCH Complete- Adrenal, Hormones and OATS ($350)
- DUTCH Cycle Mapping (480)
- DUTCH Sex Hormones Metabolites ($200)
- DUTCH Organic Acid Test Only ($200)
- DUTCH Adrenal Panel Add On Cycle Map ONLY ($75)
- DUTCH Hormones Metabolites Add On Cycle Map ($75)
- DUTCH Organic Acid Test Add On- Any ($75)
- Evexia Neurotransmitter Testing
Detoxification Testing
- Biotek Environmental Pollutants Testing ($180)
- Genova Comprehensive Toxic Elements Profile ($160)
- Genova Toxic Effects Core ($650)
Digestive, Detoxification and Neurotransmitters
- Genova Nutreval Plasma ($500)
- Genova Nutreval Plasma Insurance ($189)
- Great Plains OATS test ($325)
- Genova Nutrient and Toxic Elements Blood ($240)
- Hakala Iodine, Bromide and Fluoride ($215)
Additional dx needed for Vibrant America
- Allergic Rhinitis J305
- Dermatitis due to ingested food L272
- Other Asthma J45998
- Rash and other nonspecific skin eruption R21
Total
Note
Special Instructions
- Wait till testing is all in before scheduling next visit
- Do not need testing before next visit
- When testing arrives email to me
- 6 month follow up
- 3 month follow up
- Need testing for next visit
- When testing arrives notify me
- When testing arrives send to me and patient
- 4 month follow up
- 1 month follow up
Genova: NO Medicare, TRICARE, Aetna, Humana, Principles, BCBS Federal and North Carolina and Kaiser
Diagnostic Solutions (GI MAP): NO Medicare, HMO's OR TRICARE
Vibrant America: No medicaid or Medicare. Sharp ,Mercy, University Family,Advicare, UHC Community, Care 1st of AZ, Kaiser, Amerigroup, Scripps, Wellcare, Horizon New Jersey, Ambetter, Christian Healthcare, Bright Health, Aetna Better Health
ALL Milena insurance Is HMO

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