| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $268.75 | $268.75 | $268.75 | |
United
| Facility | $293.00 | $293.00 | $3,239.00 | |
United
| Professional | $434.51 | $655.69 | $1,042.81 |
Injection(s), autologous white blood cell concentrate (autologous protein solution), any site, including image guidance, harvesting and preparation, when performed
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $268.75 | $268.75 | $268.75 | |
United
| Facility | $293.00 | $293.00 | $3,239.00 | |
United
| Professional | $434.51 | $655.69 | $1,042.81 |