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
$228
Median
$2
High
$8.8k
Each hospital's average Blue Cross Blue Shield rate, under the methodology and billing class chosen below.
135 hospitals; the 90th percentile is 128.6× 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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160 hospital rates
iThe hospitals that file a Blue Cross Blue Shield 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 | Children's Healthcare of Atlanta Atlanta, GA percent of total billed charges · outpatientfrom % of charges | 2 | $9 | $9 | $2 | 19% | 8,514 | $7 – $11 |
| 2 | Allina Health Systems Shakopee, MN facility · other · outpatient | 2 | $18 | $20 | $7 | 36% | — | $13 – $33 |
| 3 | Allina Health Systems Shakopee, MN facility · percent of total billed charges · outpatientfrom % of charges | 3 | $24 | $26 | $9 | 33% | — | $17 – $43 |
| 4 | Allina Health Systems MN; 1175 Nininger Road. Hastings, MN facility · percent of total billed charges · outpatientfrom % of charges | 2 | $20 | $20 | $0 | 2% | — | $20 – $21 |
| 5 | Allina Health Systems Owatonna, MN facility · other · outpatient | 2 | $18 | $20 | $7 | 36% | — | $13 – $33 |
| 6 | Allina Health Systems Owatonna, MN facility · percent of total billed charges · outpatientfrom % of charges | 3 | $24 | $26 | $9 | 33% | — | $17 – $43 |
| 7 | Allina Health Systems Ulm, MN facility · fee schedule · outpatient | 1 | $23 | $23 | — | — | — | $23 – $23 |
| 8 | Allina Health Systems Ulm, MN facility · percent of total billed charges · outpatientfrom % of charges | 1 | $19 | $19 | — | — | — | $19 – $19 |
| 9 | Allina Health Systems MN 55443; 550 Osborne Road NE. Fridley, MN facility · percent of total billed charges · outpatientfrom % of charges | 1 | $21 | $21 | — | — | — | $21 – $21 |
| 10 | Allina Health Systems Cambridge, MN facility · other · outpatient | 2 | $18 | $20 | $7 | 36% | — | $13 – $33 |
| 11 | Allina Health Systems Cambridge, MN facility · percent of total billed charges · outpatientfrom % of charges | 3 | $24 | $26 | $9 | 33% | — | $17 – $43 |
| 12 | Allina Health Systems Faribualt, MN facility · other · outpatient | 2 | $18 | $20 | $7 | 36% | — | $13 – $33 |
| 13 | Allina Health Systems Faribualt, MN facility · percent of total billed charges · outpatientfrom % of charges | 3 | $24 | $26 | $9 | 33% | — | $17 – $43 |
| 14 | Allina Health Systems River Falls, WI facility · fee schedule · outpatient | 1 | $24 | $30 | $9 | 30% | — | $24 – $43 |
| 15 | Allina Health Systems River Falls, WI facility · percent of total billed charges · outpatientfrom % of charges | 1 | $21 | $27 | $8 | 30% | — | $21 – $38 |
| 16 | Allina Health Systems Minneapolis, MN facility · percent of total billed charges · outpatientfrom % of charges | 1 | $21 | $21 | — | — | — | $21 – $21 |
| 17 | Allina Health Systems Buffalo, MN facility · other · outpatient | 2 | $18 | $20 | $7 | 36% | — | $13 – $33 |
| 18 | Allina Health Systems Buffalo, MN facility · percent of total billed charges · outpatientfrom % of charges | 3 | $24 | $26 | $9 | 33% | — | $17 – $43 |
| 19 | Amisub of South Carolina, Inc. Fort Mill, SC fee schedule · outpatient | 3 | $0 | $0 | $0 | 2% | — | $0 – $0 |
| 20 | Beaufort Memorial Hospital Beaufort, SC facility · fee schedule · outpatient | 3 | $0 | $0 | — | — | — | $0 – $0 |
| 21 | Beth Israel Deaconess Hospital - Needham Needham, MA fee schedule · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 22 | Beth Israel Deaconess Hospital - Plymouth Plymouth, MA fee schedule · outpatient | 2 | $0 | $0 | — | — | — | $0 – $0 |
| 23 | Beth Israel Deaconess Hospital-Milton Inc Milton, MA fee schedule · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 24 | Beth Israel Deaconess Medical Center Boston, MA fee schedule · outpatient | 2 | $0 | $0 | — | — | — | $0 – $0 |
| 25 | Bristol Regional Medical Center BRISTOL, VA fee schedule · both | 2 | $40 | $40 | $1 | 2% | — | $39 – $41 |
← Payers reporting HCPCS A9154 · Snapshot 20261111T120946Z-9134e7f7