| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $242.71 | $242.71 | $242.71 | |
Aetna
| Professional | $242.71 | $242.71 | $292.31 | |
BCBS
| Facility | $198.03 | $240.32 | $323.31 | |
Cigna
| Professional | $116.04 | $116.04 | $116.04 |
Platelet Rich Plasma Each Unit (Special Coverage Instructions Apply. See Mcm: 2455 B)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $242.71 | $242.71 | $242.71 | |
Aetna
| Professional | $242.71 | $242.71 | $292.31 | |
BCBS
| Facility | $198.03 | $240.32 | $323.31 | |
Cigna
| Professional | $116.04 | $116.04 | $116.04 |