| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $412.43 | $412.43 | $412.43 | |
Aetna
| Professional | $176.65 | $412.43 | $412.43 | |
CareFirst
| Professional | $157.16 | $157.16 | $209.02 |
Platelets Leukocytes Reduced Irradiated Each Unit (Special Coverage Instructions Apply. See Mcm: 2455)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $412.43 | $412.43 | $412.43 | |
Aetna
| Professional | $176.65 | $412.43 | $412.43 | |
CareFirst
| Professional | $157.16 | $157.16 | $209.02 |