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Oral Adenovirus Vaccine, Type 4

Pennsylvania 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 October 2026.

How much rates vary

Facilitymedian $15 · 10th to 90th $14 to $5,012Professionalmedian $15 · 10th to 90th $15 to $15
$100$1K$10K$100Kfacility $15professional $15

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Capital Blue Cross
Setting
Facility
Modifier
None
Typical Low
$13.80
Median
$15.49
Typical High
$5,011.87
Capital Blue Cross
Setting
Professional
Modifier
None
Typical Low
$15.49
Median
$15.49
Typical High
$15.49