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
$16
High
$78
Each hospital's average Anthem rate, under the methodology and billing class chosen below.
37 hospitals; the 90th percentile is 141.3× 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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47 hospital rates
iThe hospitals that file a Anthem 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 | $15 | $15 | — | — | — | $15 – $15 |
| 2 | Blue Hill Memorial Hospital Hill, ME professional · fee schedule · outpatient | 2 | $0 | $0 | — | — | — | $0 – $0 |
| 3 | Boulder Community Health Lafayette, CO professional · fee schedule · both | 2 | $0 | $0 | — | — | — | $0 – $0 |
| 4 | CLEVELAND CLINIC AVON HOSPITAL Avon, OH facility · case rate · outpatient | 1 | $14 | $14 | — | — | — | $14 – $14 |
| 5 | CLEVELAND CLINIC CHILDREN'S HOSPITAL FOR REHABILITATION Cleveland, OH facility · case rate · outpatient | 1 | $26 | $26 | — | — | — | $26 – $26 |
| 6 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Mentor, OH facility · case rate · outpatient | 1 | $16 | $16 | — | — | — | $16 – $16 |
| 7 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Euclid, OH facility · case rate · outpatient | 1 | $16 | $16 | — | — | — | $16 – $16 |
| 8 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Warrensville Heights, OH facility · case rate · outpatient | 1 | $17 | $17 | — | — | — | $17 – $17 |
| 9 | Central Georgia Rehabilitation LLC Macon, GA percent of total billed charges · outpatientfrom % of charges | 1 | $50 | $50 | — | — | — | $50 – $50 |
| 10 | Charles A. Dean Memorial Hospital Greenville, ME professional · fee schedule · outpatient | 2 | $0 | $0 | — | — | — | $0 – $0 |
| 11 | Cleveland Clinic Mercy Hospital Canton, OH facility · case rate · outpatient | 1 | $15 | $15 | — | — | — | $15 – $15 |
| 12 | Eastern Maine Medical Center Bangor, ME facility · percent of total billed charges · inpatientfrom % of charges | 2 | $1 | $1 | — | — | — | $1 – $1 |
| 13 | Eastern Maine Medical Center Bangor, ME facility · percent of total billed charges · outpatientfrom % of charges | 2 | $1 | $1 | — | — | — | $1 – $1 |
| 14 | Eastern Maine Medical Center Bangor, ME professional · fee schedule · outpatient | 2 | $0 | $0 | — | — | — | $0 – $0 |
| 15 | Fairview Hospital Cleveland, OH facility · case rate · outpatient | 1 | $15 | $15 | — | — | — | $15 – $15 |
| 16 | Fisher-Titus Medical Center Norwalk, OH facility · case rate · outpatient | 1 | $10 | $10 | — | — | — | $10 – $10 |
| 17 | Floyd Healthcare Management Inc Rome, GA percent of total billed charges · inpatientfrom % of charges | 1 | $78 | $78 | — | — | — | $78 – $78 |
| 18 | Floyd Healthcare Management Inc Rome, GA percent of total billed charges · outpatientfrom % of charges | 3 | $78 | $76 | $2 | 3% | — | $73 – $78 |
| 19 | GOOD SAMARITAN MEDICAL CENTER, LLC DBA LAFAYETTE, CO facility · percent of total billed charges · inpatientfrom % of charges | 1 | $56 | $56 | — | — | — | $56 – $56 |
| 20 | GOOD SAMARITAN MEDICAL CENTER, LLC DBA LAFAYETTE, CO facility · percent of total billed charges · outpatientfrom % of charges | 4 | $26 | $34 | $13 | 38% | — | $26 – $56 |
| 21 | INTERMOUNTAIN FRONT RANGE INC. DBA INTERMOUNTAIN HEALTH LUTHERAN HOSPITAL WHEAT RIDGE, CO facility · percent of total billed charges · inpatientfrom % of charges | 1 | $56 | $56 | — | — | — | $56 – $56 |
| 22 | INTERMOUNTAIN FRONT RANGE INC. DBA INTERMOUNTAIN HEALTH LUTHERAN HOSPITAL WHEAT RIDGE, CO facility · percent of total billed charges · outpatientfrom % of charges | 5 | $26 | $32 | $12 | 36% | — | $26 – $56 |
| 23 | LODI COMMUNITY HOSPITAL Lodi, OH facility · case rate · outpatient | 1 | $25 | $25 | — | — | — | $25 – $25 |
| 24 | LUTHERAN HOSPITAL Cleveland, OH facility · case rate · outpatient | 1 | $15 | $15 | — | — | — | $15 – $15 |
| 25 | MARYMOUNT HOSPITAL INC Garfield Heights, OH facility · case rate · outpatient | 1 | $14 | $14 | — | — | — | $14 – $14 |
← Payers reporting HCPCS A9154 · Snapshot 20261111T120946Z-9134e7f7