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Oral Adenovirus Vaccine, Type 4

Illinois rates for HCPCS 90476

A live vaccine against adenovirus type 4, one of the viruses that causes respiratory illness, supplied as a capsule to be swallowed. It is used in settings where outbreaks of this infection spread rapidly among people living in close quarters. This covers the vaccine product itself; giving it is charged separately.

Rates data updated October 2026.

How much rates vary

Facilitymedian $100 · 10th to 90th $100 to $100Professionalmedian $20 · 10th to 90th $15 to $105
$20$50$100$200facility $100professional $20

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Hally Health
Setting
Professional
Modifier
None
Typical Low
$14.79
Median
$20.89
Typical High
$104.71
Hally Health
Setting
Facility
Modifier
None
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
None
Typical Low
$17.38
Median
$17.78
Typical High
$19.05
Molina
Setting
Professional
Modifier
None
Typical Low
$30.20
Median
$30.20
Typical High
$30.20