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.
Generation details were not recorded for this description.
Original text from hospital filings
HC Dental Sealant per Tooth
Low
$34
Average
$637
Median
$879
High
$1.8k
Each hospital's average Caresource rate, under the methodology and billing class chosen below.
31 hospitals; the 90th percentile is 44.0× the 10th. Each bar is a price range and its height is how many hospitals fall in it. Hover a bar, or a row in the ladder, for details.
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32 hospital rates
iThe hospitals that file a Caresource rate for this code, one row per hospital and set of terms (billing class, payment method, setting). Rates under different terms are never blended, so the terms are shown under each hospital’s name. Figures are the hospital’s averages across its plans.| # | Plans | |||||||
|---|---|---|---|---|---|---|---|---|
| 1 | AKRON GENERAL MEDICAL CENTER Akron, OH facility · case rate · outpatient | 1 | $879 | $879 | — | — | — | $879 – $879 |
| 2 | Arkansas Childrens Hospital Little Rock, AR facility · other · outpatient | 1 | $57 | $57 | — | — | — | $57 – $57 |
| 3 | Brandon HMA LLC Brandon, MS facility · other · outpatient | 1 | $34 | $34 | — | — | — | $34 – $34 |
| 4 | CLEVELAND CLINIC AVON HOSPITAL Avon, OH facility · case rate · outpatient | 1 | $912 | $912 | — | — | — | $912 – $912 |
| 5 | CLEVELAND CLINIC CHILDREN'S HOSPITAL FOR REHABILITATION Cleveland, OH facility · case rate · outpatient | 1 | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
| 6 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Mentor, OH facility · case rate · outpatient | 1 | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
| 7 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Euclid, OH facility · case rate · outpatient | 1 | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
| 8 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Warrensville Heights, OH facility · case rate · outpatient | 1 | $1.1k | $1.1k | — | — | — | $1.1k – $1.1k |
| 9 | Charleston Area Medical Center Charleston, WV percent of total billed charges · bothfrom % of charges | 1 | $27 | $27 | — | — | — | $27 – $27 |
| 10 | Charleston Area Medical Center Charleston, WV percent of total billed charges · outpatientfrom % of charges | 1 | $46 | $46 | — | — | — | $46 – $46 |
| 11 | Cleveland Clinic Mercy Hospital Canton, OH facility · case rate · outpatient | 1 | $883 | $883 | — | — | — | $883 – $883 |
| 12 | East Georgia Regional Medical Center LLC Statesboro, GA facility · percent of total billed charges · outpatientfrom % of charges | 1 | $1.8k | $1.8k | — | — | — | $1.8k – $1.8k |
| 13 | Fairview Hospital Cleveland, OH facility · case rate · outpatient | 1 | $970 | $970 | — | — | — | $970 – $970 |
| 14 | Fisher-Titus Medical Center Norwalk, OH facility · case rate · outpatient | 1 | $648 | $648 | — | — | — | $648 – $648 |
| 15 | LODI COMMUNITY HOSPITAL Lodi, OH facility · case rate · outpatient | 1 | $1.5k | $1.5k | — | — | — | $1.5k – $1.5k |
| 16 | LUTHERAN HOSPITAL Cleveland, OH facility · case rate · outpatient | 1 | $924 | $924 | — | — | — | $924 – $924 |
| 17 | MARYMOUNT HOSPITAL INC Garfield Heights, OH facility · case rate · outpatient | 1 | $912 | $912 | — | — | — | $912 – $912 |
| 18 | MEDINA HOSPITAL Medina, OH facility · case rate · outpatient | 1 | $946 | $946 | — | — | — | $946 – $946 |
| 19 | Natchez Hospital Company LLC Natchez, MS facility · other · outpatient | 1 | $34 | $34 | — | — | — | $34 – $34 |
| 20 | Nationwide Children's Hospital Columbus, OH facility · other · outpatient | 1 | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
| 21 | PRISMA HEALTH BAPTIST EASLEY HOSPITAL EASLEY, SC percent of total billed charges · bothfrom % of charges | 1 | $51 | $51 | — | — | — | $51 – $51 |
| 22 | PRISMA HEALTH GREENVILLE MEMORIAL HOSPITAL GREENVILLE, SC percent of total billed charges · bothfrom % of charges | 1 | $51 | $51 | — | — | — | $51 – $51 |
| 23 | PRISMA HEALTH GREER MEMORIAL HOSPITAL GREER, SC percent of total billed charges · bothfrom % of charges | 1 | $51 | $51 | — | — | — | $51 – $51 |
| 24 | PRISMA HEALTH HILLCREST HOSPITAL SIMPSONVILLE, SC percent of total billed charges · bothfrom % of charges | 1 | $65 | $65 | — | — | — | $65 – $65 |
| 25 | PRISMA HEALTH LAURENS COUNTY HOSPITAL CLINTON, SC percent of total billed charges · bothfrom % of charges | 1 | $113 | $113 | — | — | — | $113 – $113 |
← Payers reporting HCPCS D1351 · Snapshot 20261111T120946Z-9134e7f7