| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $85.03 | $85.03 | $85.03 | |
Aetna
| Professional | $85.03 | $85.03 | $85.03 | |
Medica
| Facility | $157.94 | $166.47 | $216.39 | |
Medica
| Professional | $631.91 | $631.91 | $631.91 |
Platelets Each Unit (Special Coverage Instructions Apply. See Mcm: 2455 B)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $85.03 | $85.03 | $85.03 | |
Aetna
| Professional | $85.03 | $85.03 | $85.03 | |
Medica
| Facility | $157.94 | $166.47 | $216.39 | |
Medica
| Professional | $631.91 | $631.91 | $631.91 |