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South Dakota rates for HCPCS 90476

Adenovirus vaccine, type 4, live, for oral use

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.00 / $141.00 / $141.00
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.20 / $51.20 / $51.20