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Illinois rates for HCPCS 90476

Adenovirus Vaccine Type 4 Live Oral

Insurance Carrier
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.92 / $21.55 / $109.60
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.51 / $17.64 / $19.27
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $30.00 / $30.00