| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $4,294.16 | $4,294.16 | $4,294.16 | |
Cigna
| Professional | $4,294.16 | $4,294.16 | $4,294.16 | |
United
| Professional | $3,999.46 | $4,209.96 | $6,314.94 |
Indium In-111 labeled autologous platelets, diagnostic, per study dose
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $4,294.16 | $4,294.16 | $4,294.16 | |
Cigna
| Professional | $4,294.16 | $4,294.16 | $4,294.16 | |
United
| Professional | $3,999.46 | $4,209.96 | $6,314.94 |