| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
BCBS
| Professional | $16.67 | $16.67 | $16.67 | |
Wellpoint
| Professional | $0.76 | $0.76 | $1.03 |
Adenovirus Vaccine Type 4 Live Oral
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
BCBS
| Professional | $16.67 | $16.67 | $16.67 | |
Wellpoint
| Professional | $0.76 | $0.76 | $1.03 |