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Illinois rates for HCPCS 90476

Adenovirus vaccine, type 4, live, for oral use

Facilitymedian $100 · 10th–90th $100–$1000%50%100%$100Professionalmedian $23 · 10th–90th $15–$1380%10%10th90th$23$10.0$20.0$50.0$100.0$200.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14.79 / $23.44 / $138.04
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17.38 / $17.78 / $19.05
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $30.20