| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Molina
| Professional | $78.00 | $78.00 | $78.00 | |
Regence BlueShield
| Facility | $50.60 | $88.00 | $554.87 |
Adenovirus Vaccine Type 4 Live Oral
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Molina
| Professional | $78.00 | $78.00 | $78.00 | |
Regence BlueShield
| Facility | $50.60 | $88.00 | $554.87 |