| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Molina
| Professional | $17.00 | $17.00 | $20.00 |
Adenovirus Vaccine Type 4 Live Oral
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Molina
| Professional | $17.00 | $17.00 | $20.00 |