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Oral Adenovirus Vaccine, Type 4

Ohio 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.

Facilitymedian $115 · 10th–90th $110$1260%50%10th90th$115Professionalmedian $5 · 10th–90th $0$1200%20%10th90th$5$0.0$0.1$0.5$2.0$10.0$50.0

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
Aetna
Setting
Facility
Modifier
Global
Typical Low
$109.65
Median
$114.82
Typical High
$125.89
Aetna
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$120.23
Typical High
$125.89
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$0.02
Median
$5.50
Typical High
$5.50
Cigna
Setting
Professional
Modifier
Global
Typical Low
$28.84
Median
$28.84
Typical High
$28.84
Molina
Setting
Professional
Modifier
Global
Typical Low
$39.81
Median
$50.12
Typical High
$50.12
SummaCare
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$60.26
Typical High
$60.26