MEBO Research offers a TMAU Test with the Cleveland Clinic that will test for both Primary (genetic) and Secondary (acquired) TMAU. You do not need doctor's orders or referral. The cost of this test is $150 plus round trip shipping. The kit will be shipped to you from Miami, Florida with a return label for you to ship your urine sample back to Miami. I really can't quote the shipping cost without knowing your address, since UPS won't give a shipping rate without a full street address, but usually it is $170 to $200 for everything. There would not be any additional cost other than the test cost of $150 plus round trip shipping; you would not have to ship with dry ice, and there is no charge for the kit.