Good news! There are providers in your state who can handle your request. Based on your request and location, we need to pre-authorize payment of $201.03.
Request Summary
Requested Service
Chlamydia / Gonorrhea RNA Test
HIV 1 & 2 Ab Test
HSV 1 & 2 Ab (IgG) Test
Hepatitis B Surface Antigen Test
Hepatitis C Antibody Test
RPR Test
Lab testing fees
$146.27
Medical provider and platform fees
$54.76
Total:
$201.03
Complete the form below to submit your request. All fields are required.