| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Anthem BCBS
| Professional | $17.10 | $111.00 | $111.00 | |
Hometown Health
| Professional | $0.22 | $22.00 | $190.00 | |
United
| Facility | $375.88 | $375.88 | $375.88 |
Adenovirus vaccine, type 4, live, for oral use
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Anthem BCBS
| Professional | $17.10 | $111.00 | $111.00 | |
Hometown Health
| Professional | $0.22 | $22.00 | $190.00 | |
United
| Facility | $375.88 | $375.88 | $375.88 |