| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $58.28 | $58.28 | $109.40 | |
Providence
| Facility | $58.28 | $58.28 | $120.34 | |
Providence
| Professional | $1,800,000.00 | $2,250,000.00 | $2,400,000.00 |
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 | $109.40 | |
Providence
| Facility | $58.28 | $58.28 | $120.34 | |
Providence
| Professional | $1,800,000.00 | $2,250,000.00 | $2,400,000.00 |