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Oral Adenovirus Vaccine, Type 4

Minnesota 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.

How much rates vary

Facilitymedian $631 · 10th to 90th $631 to $955
$200$500$1Kfacility $631

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$208.93
Median
$208.93
Typical High
$208.93
BCBS
Setting
Facility
Modifier
Global
Typical Low
$630.96
Median
$630.96
Typical High
$954.99