| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $58.28 | $58.28 | $58.28 | |
Aetna
| Professional | $58.28 | $58.28 | $106.19 | |
Anthem BCBS
| Professional | $22.50 | $30.00 | $33.00 | |
United
| Professional | $80.56 | $80.56 | $80.56 |
Platelets Irradiated Each Unit (Special Coverage Instructions Apply. See Mcm: 2455)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $58.28 | $58.28 | $58.28 | |
Aetna
| Professional | $58.28 | $58.28 | $106.19 | |
Anthem BCBS
| Professional | $22.50 | $30.00 | $33.00 | |
United
| Professional | $80.56 | $80.56 | $80.56 |