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Pennsylvania rates for HCPCS 90476

Adenovirus vaccine, type 4, live, for oral use

Insurance Carrier
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.27 / $15.61 / $8,639.91
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.61 / $15.61 / $15.61