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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
$13.18 / $15.49 / $5,011.87
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.49 / $15.49 / $15.49
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.71 / $45.71 / $45.71