| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Capital Blue Cross
| Facility | $13.27 | $15.61 | $8,639.91 | |
Capital Blue Cross
| Professional | $15.61 | $15.61 | $15.61 |
Adenovirus Vaccine Type 4 Live Oral
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Capital Blue Cross
| Facility | $13.27 | $15.61 | $8,639.91 | |
Capital Blue Cross
| Professional | $15.61 | $15.61 | $15.61 |