| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Capital Blue Cross
| Facility | $13.18 | $15.49 | $5,011.87 | |
Capital Blue Cross
| Professional | $15.49 | $15.49 | $15.49 | |
United
| Facility | $45.71 | $45.71 | $45.71 |
Adenovirus vaccine, type 4, live, for oral use
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Capital Blue Cross
| Facility | $13.18 | $15.49 | $5,011.87 | |
Capital Blue Cross
| Professional | $15.49 | $15.49 | $15.49 | |
United
| Facility | $45.71 | $45.71 | $45.71 |