| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $163.77 | $175.28 | $175.28 |
Platelets Leukocytes Reduced Each Unit (Special Coverage Instructions Apply. See Mcm: 2455)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $163.77 | $175.28 | $175.28 |