Saliva substitute combination kit No. 2

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

SALIVA SUBSTITUTE COMBO NO.9 MOUTHWASH

Ambetter pricing summary

Low

Average

$46

Median

$39

High

$91

Ambetter rate distribution

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44 hospital rates

#		Plans
1	Alleghany County Memorial Hospital, Inc Sparta, NC facility · percent of total billed charges · outpatientfrom % of charges	1	$90	$90	—	—	—	$90 – $90
2	Atrium Health Hospitals Inc Kings Mountain, NC percent of total billed charges · outpatientfrom % of charges	2	$20	$20	$1	6%	—	$19 – $22
3	Atrium Health Hospitals Inc Lincolnton, NC percent of total billed charges · inpatientfrom % of charges	2	$21	$21	$1	5%	—	$20 – $22
4	Atrium Health Hospitals Inc Lincolnton, NC percent of total billed charges · outpatientfrom % of charges	2	$21	$21	$1	6%	—	$20 – $22
5	Atrium Health Hospitals Inc Wadesboro, NC percent of total billed charges · inpatientfrom % of charges	2	$21	$21	$2	8%	—	$19 – $22
6	Atrium Health Hospitals Inc Wadesboro, NC percent of total billed charges · outpatientfrom % of charges	2	$20	$20	$2	10%	—	$18 – $22
7	Bristol Regional Medical Center BRISTOL, VA fee schedule · both	1	$85	$85	—	—	—	$85 – $85
8	Carolinas Medical Center Charlotte, NC percent of total billed charges · outpatientfrom % of charges	2	$19	$19	$2	11%	—	$17 – $22
9	Carolinas Medical Center Charlotte, NC percent of total billed charges · inpatientfrom % of charges	2	$27	$27	$1	5%	—	$25 – $28
10	Carolinas Medical Center Charlotte, NC percent of total billed charges · outpatientfrom % of charges	2	$26	$26	$2	8%	—	$24 – $28
11	Carolinas Medical Center Charlotte, NC percent of total billed charges · outpatientfrom % of charges	2	$19	$19	$2	11%	—	$17 – $22
12	Central Georgia Rehabilitation LLC Macon, GA percent of total billed charges · inpatientfrom % of charges	1	$53	$53	—	—	—	$53 – $53
13	Central Georgia Rehabilitation LLC Macon, GA percent of total billed charges · outpatientfrom % of charges	1	$31	$31	—	—	—	$31 – $31
14	Children's Healthcare of Atlanta Atlanta, GA percent of total billed charges · outpatientfrom % of charges	1	$7	$7	—	—	—	$7 – $7
15	Children's Healthcare of Atlanta Atlanta, GA percent of total billed charges · outpatientfrom % of charges	1	$7	$7	—	—	—	$7 – $7
16	Greeneville Community Hospital GREENEVILLE, TN fee schedule · both	1	$85	$85	—	—	—	$85 – $85
17	Hancock County Hospital SNEEDVILLE, TN percent of total billed charges · bothfrom % of charges	1	$32	$32	—	—	—	$32 – $32
18	Hawkins County Memorial Hospital ROGERSVILLE, TN fee schedule · both	1	$85	$85	—	—	—	$85 – $85
19	High Point Regional Health High Point, NC percent of total billed charges · outpatientfrom % of charges	1	$33	$33	—	—	—	$33 – $33
20	Holston Valley Medical Center KINGSPORT, TN fee schedule · both	1	$85	$85	—	—	—	$85 – $85
21	Indian Path Community Hospital KINGSPORT, TN fee schedule · both	1	$85	$85	—	—	—	$85 – $85
22	Johnston Memorial Hospital ABINGDON, VA fee schedule · both	1	$91	$91	—	—	—	$91 – $91
23	Lee County Community Hospital PENNINGTON GAP, VA percent of total billed charges · bothfrom % of charges	1	$39	$39	—	—	—	$39 – $39
24	Lexington Medical Center Lexington, NC percent of total billed charges · outpatientfrom % of charges	1	$41	$41	—	—	—	$41 – $41
25	Lonesome Pine Hospital NORTON, VA fee schedule · both	1	$85	$85	—	—	—	$85 – $85