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Ohio rates for HCPCS 90476

Adenovirus vaccine, type 4, live, for oral use

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