go back

Washington rates for HCPCS 90476

Adenovirus vaccine, type 4, live, for oral use

Facilitymedian $72 · 10th–90th $46–$1550%10%20%10th90th$72Professionalmedian $50 · 10th–90th $50–$500%50%100%$50$50.0$100.0$200.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$45.71 / $69.18 / $147.91
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $50.12 / $50.12
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$45.71 / $45.71 / $45.71
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$52.48 / $154.88 / $154.88
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$45.71 / $72.44 / $190.55