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Oral Adenovirus Vaccine, Type 4

Montana 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 $79 · 10th–90th $60$850%50%10th90th$79

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
Providence
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$79.43
Typical High
$85.11