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Oral Adenovirus Vaccine, Type 4

Michigan 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 July 2026.

Professionalmedian $29 · 10th–90th $29$290%50%$29$0.1$0.2$1.0$5.0$20.0$100.0

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

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$107.15
Typical High
$107.15
Cigna
Setting
Professional
Modifier
Global
Typical Low
$28.84
Median
$28.84
Typical High
$28.84
Health Alliance Plan
Setting
Professional
Modifier
Global
Typical Low
$0.04
Median
$0.04
Typical High
$28.84
Priority Health
Setting
Professional
Modifier
Global
Typical Low
$28.84
Median
$28.84
Typical High
$28.84