| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $58.28 | $58.28 | $99.45 | |
CareFirst
| Professional | $162.32 | $162.32 | $267.83 | |
Cigna
| Facility | $117.06 | $117.06 | $117.06 | |
Cigna
| Professional | $39.60 | $39.60 | $114.90 |
Platelets Irradiated Each Unit (Special Coverage Instructions Apply. See Mcm: 2455)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $58.28 | $58.28 | $99.45 | |
CareFirst
| Professional | $162.32 | $162.32 | $267.83 | |
Cigna
| Facility | $117.06 | $117.06 | $117.06 | |
Cigna
| Professional | $39.60 | $39.60 | $114.90 |