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
$22
Median
$11
High
$514
Each hospital's average Aetna rate, under the methodology and billing class chosen below.
127 hospitals; the 90th percentile is 154.0× 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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182 hospital rates
iThe hospitals that file a Aetna 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 · fee schedule · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 2 | Abington Memorial Hospital Abington, PA facility · fee schedule · outpatient | 2 | $1 | $1 | $0 | 5% | — | $1 – $1 |
| 3 | Alleghany County Memorial Hospital, Inc Sparta, NC facility · percent of total billed charges · outpatientfrom % of charges | 1 | $90 | $90 | — | — | — | $90 – $90 |
| 4 | Allina Health Systems Shakopee, MN facility · percent of total billed charges · inpatientfrom % of charges | 3 | $32 | $34 | $11 | 33% | — | $24 – $58 |
| 5 | Allina Health Systems Shakopee, MN facility · percent of total billed charges · outpatientfrom % of charges | 3 | $32 | $34 | $11 | 33% | — | $24 – $58 |
| 6 | Allina Health Systems MN; 1175 Nininger Road. Hastings, MN facility · percent of total billed charges · outpatientfrom % of charges | 3 | $20 | $23 | $5 | 20% | — | $19 – $29 |
| 7 | Allina Health Systems Owatonna, MN facility · percent of total billed charges · inpatientfrom % of charges | 3 | $32 | $34 | $11 | 33% | — | $24 – $58 |
| 8 | Allina Health Systems Owatonna, MN facility · percent of total billed charges · outpatientfrom % of charges | 3 | $32 | $34 | $11 | 33% | — | $24 – $58 |
| 9 | Allina Health Systems Ulm, MN facility · percent of total billed charges · inpatientfrom % of charges | 3 | $33 | $35 | $5 | 14% | — | $31 – $42 |
| 10 | Allina Health Systems Ulm, MN facility · percent of total billed charges · outpatientfrom % of charges | 3 | $33 | $36 | $5 | 14% | — | $31 – $43 |
| 11 | Allina Health Systems MN 55443; 550 Osborne Road NE. Fridley, MN facility · percent of total billed charges · outpatientfrom % of charges | 3 | $20 | $23 | $5 | 20% | — | $19 – $29 |
| 12 | Allina Health Systems Cambridge, MN facility · percent of total billed charges · inpatientfrom % of charges | 3 | $32 | $34 | $11 | 33% | — | $24 – $58 |
| 13 | Allina Health Systems Cambridge, MN facility · percent of total billed charges · outpatientfrom % of charges | 3 | $32 | $34 | $11 | 33% | — | $24 – $58 |
| 14 | Allina Health Systems Faribualt, MN facility · percent of total billed charges · inpatientfrom % of charges | 3 | $32 | $34 | $11 | 33% | — | $24 – $58 |
| 15 | Allina Health Systems Faribualt, MN facility · percent of total billed charges · outpatientfrom % of charges | 3 | $32 | $34 | $11 | 33% | — | $24 – $58 |
| 16 | Allina Health Systems River Falls, WI facility · percent of total billed charges · inpatientfrom % of charges | 3 | $46 | $48 | $16 | 33% | — | $33 – $82 |
| 17 | Allina Health Systems River Falls, WI facility · percent of total billed charges · outpatientfrom % of charges | 3 | $46 | $49 | $16 | 33% | — | $33 – $83 |
| 18 | Allina Health Systems Minneapolis, MN facility · percent of total billed charges · outpatientfrom % of charges | 3 | $20 | $23 | $5 | 20% | — | $19 – $29 |
| 19 | Allina Health Systems Buffalo, MN facility · percent of total billed charges · inpatientfrom % of charges | 3 | $32 | $34 | $11 | 33% | — | $24 – $58 |
| 20 | Allina Health Systems Buffalo, MN facility · percent of total billed charges · outpatientfrom % of charges | 3 | $32 | $34 | $11 | 33% | — | $24 – $58 |
| 21 | Alta Newport Hospital, LLC Tustin, CA facility · case rate · outpatient | 2 | $1 | $1 | — | — | — | $1 – $1 |
| 22 | Atrium Health Hospitals Inc Kings Mountain, NC percent of total billed charges · inpatientfrom % of charges | 5 | $28 | $29 | $10 | 33% | — | $18 – $46 |
| 23 | Atrium Health Hospitals Inc Kings Mountain, NC percent of total billed charges · outpatientfrom % of charges | 5 | $31 | $30 | $10 | 34% | — | $16 – $46 |
| 24 | Atrium Health Hospitals Inc Lincolnton, NC percent of total billed charges · inpatientfrom % of charges | 5 | $28 | $30 | $11 | 36% | — | $18 – $51 |
| 25 | Atrium Health Hospitals Inc Lincolnton, NC percent of total billed charges · outpatientfrom % of charges | 5 | $31 | $31 | $12 | 37% | — | $16 – $51 |
← Payers reporting HCPCS A9154 · Snapshot 20261111T120946Z-9134e7f7