| 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 | |
CareFirst
| Professional | $162.32 | $162.32 | $215.89 |
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 | |
CareFirst
| Professional | $162.32 | $162.32 | $215.89 |