| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $4,168.69 | $4,265.80 | $4,265.80 | |
Cigna
| Professional | $4,265.80 | $4,265.80 | $4,265.80 | |
United
| Professional | $4,168.69 | $4,168.69 | $9,772.37 |
Indium In-111 labeled autologous platelets, diagnostic, per study dose
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $4,168.69 | $4,265.80 | $4,265.80 | |
Cigna
| Professional | $4,265.80 | $4,265.80 | $4,265.80 | |
United
| Professional | $4,168.69 | $4,168.69 | $9,772.37 |