| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $603.50 | $603.50 | $603.50 | |
Aetna
| Professional | $585.04 | $585.04 | $603.50 | |
Horizon BCBS
| Facility | $964.78 | $2,407.29 | $2,655.00 |
Platelets Pheresis Irradiated Each Unit (Special Coverage Instructions Apply. See Mcm: 2455)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $603.50 | $603.50 | $603.50 | |
Aetna
| Professional | $585.04 | $585.04 | $603.50 | |
Horizon BCBS
| Facility | $964.78 | $2,407.29 | $2,655.00 |