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.
Original text from hospital filings
SALIVA SUBSTITUTE COMBO NO.9 MOUTHWASH
Low
$0
Average
$35
Median
$23
High
$297
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
38 payers; the 90th percentile is 142.0× the 10th. Each bar is a price range and its height is how many payers fall in it. Hover a bar, or a row in the ladder, for details.
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| # | ||||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Cigna fee schedule · outpatient · +11 other terms | 109 | $1 | $1 | $1 | 74% | — | $0 – $3 |
| 2 | Blue Cross Blue Shield fee schedule · outpatient · +10 other terms | 65 | $1 | $1 | $1 | 45% | — | $0 – $2 |
| 3 | MultiPlan percent of total billed charges · outpatientfrom % of charges · +4 other terms | 36 | $55 | $54 | $29 | 53% | — | $11 – $130 |
| 4 | Aetna facility · fee schedule · outpatient · +10 other terms | 27 | $1 | $1 | $0 | 26% | — | $0 – $1 |
| 5 | UnitedHealthcare facility · case rate · outpatient · +14 other terms | 23 | $15 | $7 | $9 | 124% | — | $0 – $27 |
| 6 | Beechstreet percent of total billed charges · inpatientfrom % of charges · +1 other terms | 16 | $54 | $67 | $23 | 34% | — | $52 – $127 |
| 7 | Medcost percent of total billed charges · inpatientfrom % of charges · +4 other terms | 16 | $36 | $41 | $15 | 36% | — | $18 – $96 |
| 8 | Anthem facility · case rate · outpatient · +7 other terms | 15 | $15 | $17 | $4 | 23% | — | $10 – $26 |
| 9 | Caresource facility · case rate · outpatient · +2 other terms | 15 | $16 | $17 | $4 | 23% | — | $10 – $27 |
| 10 | Molina facility · case rate · outpatient · +8 other terms | 15 | $15 | $17 | $4 | 23% | — | $11 – $26 |
| 11 | Ucare facility · percent of total billed charges · inpatientfrom % of charges · +1 other terms | 13 | $0 | $0 | $0 | 76% | — | $0 – $1 |
| 12 | Bcbs Nc percent of total billed charges · outpatientfrom % of charges · +2 other terms | 12 | $18 | $18 | $1 | 7% | — | $11 – $19 |
| 13 | Highmark fee schedule · outpatient · +4 other terms | 11 | $0 | $0 | $0 | 8% | — | $0 – $0 |
| 14 | Optum facility · case rate · outpatient | 11 | $14 | $16 | $4 | 22% | — | $13 – $24 |
| 15 | Ambetter fee schedule · both · +4 other terms | 10 | $85 | $86 | $2 | 2% | — | $85 – $91 |
| 16 | Bcbs Mn facility · percent of total billed charges · outpatientfrom % of charges | 10 | $24 | $22 | $8 | 36% | — | $10 – $41 |
| 17 | Devoted fee schedule · both · +1 other terms | 10 | $39 | $39 | $1 | 2% | — | $39 – $42 |
| 18 | Humana fee schedule · both · +7 other terms | 10 | $39 | $39 | $1 | 2% | — | $39 – $42 |
| 19 | Magellan percent of total billed charges · outpatientfrom % of charges | 10 | $36 | $36 | — | — | — | $36 – $36 |
| 20 | Oscar percent of total billed charges · outpatientfrom % of charges · +1 other terms | 8 | $25 | $27 | $16 | 59% | — | $7 – $56 |
| 21 | WellCare fee schedule · both · +4 other terms | 8 | $41 | $42 | $1 | 2% | — | $41 – $44 |
| 22 | Aetna Better Health percent of total billed charges · outpatientfrom % of charges · +2 other terms | 5 | $5 | $5 | $0 | 7% | — | $5 – $5 |
| 23 | Excellus facility · fee schedule · outpatient | 5 | $0 | $0 | $0 | 61% | — | $0 – $1 |
| 24 | Medicaid fee schedule · outpatient · +1 other terms | 5 | $1 | $1 | — | — | — | $1 – $1 |
| 25 | Medicare facility · percent of total billed charges · outpatientfrom % of charges | 5 | $11 | $12 | $2 | 19% | — | $10 – $17 |
← Hospitals reporting HCPCS A9154 · Snapshot 20261111T120946Z-9134e7f7