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
$18
Median
$22
High
$46
Each hospital's average Healthpartners rate, under the methodology and billing class chosen below.
21 hospitals; the 90th percentile is 181.5× 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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21 hospital rates
iThe hospitals that file a Healthpartners 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 | Allina Health Systems Owatonna, MN facility · other · outpatient | 1 | $36 | $46 | $14 | 30% | — | $36 – $66 |
| 2 | Allina Health Systems Cambridge, MN facility · other · outpatient | 1 | $36 | $46 | $14 | 30% | — | $36 – $66 |
| 3 | Allina Health Systems Faribualt, MN facility · other · outpatient | 1 | $36 | $46 | $14 | 30% | — | $36 – $66 |
| 4 | Allina Health Systems Buffalo, MN facility · other · outpatient | 1 | $36 | $46 | $14 | 30% | — | $36 – $66 |
| 5 | Essentia Health Ada 201 9th St W Ada, MN facility · percent of total billed charges · inpatientfrom % of charges | 3 | $0 | $0 | $0 | 77% | — | $0 – $1 |
| 6 | Essentia Health Deer River 115 10th Ave NE Deer River, MN facility · percent of total billed charges · inpatientfrom % of charges | 3 | $0 | $0 | $0 | 80% | — | $0 – $1 |
| 7 | Essentia Health Fosston 900 Hilligoss Blvd SE Fosston, MN facility · percent of total billed charges · inpatientfrom % of charges | 3 | $0 | $0 | $0 | 77% | — | $0 – $1 |
| 8 | Essentia Health Holy Trinity Hospital Graceville, MN facility · percent of total billed charges · inpatientfrom % of charges | 3 | $0 | $0 | $0 | 77% | — | $0 – $1 |
| 9 | Essentia Health Northern Pines 5211 Highway 110 Aurora, MN facility · percent of total billed charges · inpatientfrom % of charges | 3 | $0 | $0 | $0 | 80% | — | $0 – $1 |
| 10 | Essentia Health Sandstone 705 Lundorff Dr Sandstone, MN facility · percent of total billed charges · inpatientfrom % of charges | 3 | $0 | $0 | $0 | 80% | — | $0 – $1 |
| 11 | Essentia Health St Marys Hospital-Superior 3500 Tower Ave Superior, WI facility · percent of total billed charges · inpatientfrom % of charges | 3 | $0 | $0 | $0 | 80% | — | $0 – $1 |
| 12 | Essentia Health Virginia 901 9th St N Virginia, MN facility · percent of total billed charges · inpatientfrom % of charges | 2 | $0 | $0 | $0 | 76% | — | $0 – $1 |
| 13 | ThedaCare Regional Medical Center-Berlin Inc WI 54971-9286; N2930 State Rd 22 Wautoma, WI facility · percent of total billed charges · outpatientfrom % of charges | 1 | $21 | $22 | $4 | 19% | — | $18 – $30 |
| 14 | Thedacare Regional Medical Center-Appleton Inc WI 54911; W5282 Amy Ave. Appleton WI 54911-7233; 2500 E Capital Dr. Appleton, WI facility · percent of total billed charges · outpatientfrom % of charges | 1 | $21 | $22 | $4 | 19% | — | $18 – $30 |
| 15 | Thedacare Regional Medical Center-Appleton Inc Fond Du Lac, WI facility · percent of total billed charges · outpatientfrom % of charges | 1 | $21 | $22 | $4 | 19% | — | $18 – $30 |
| 16 | Thedacare Regional Medical Center-Appleton Inc Oshkosh, WI facility · percent of total billed charges · outpatientfrom % of charges | 1 | $21 | $22 | $4 | 19% | — | $18 – $30 |
| 17 | Thedacare Regional Medical Center-Appleton Inc. Appleton, WI facility · percent of total billed charges · outpatientfrom % of charges | 1 | $21 | $22 | $4 | 19% | — | $18 – $30 |
| 18 | Thedacare Regional Medical Center-New London Inc WI 54961; 370 S. Main St. Clintonville, WI facility · percent of total billed charges · outpatientfrom % of charges | 1 | $21 | $22 | $4 | 19% | — | $18 – $30 |
| 19 | Thedacare Regional Medical Center-Shawano Inc Shawano, WI facility · percent of total billed charges · outpatientfrom % of charges | 1 | $21 | $22 | $4 | 19% | — | $18 – $30 |
| 20 | Thedacare Regional Medical Center-Waupaca Inc Waupaca, WI facility · percent of total billed charges · outpatientfrom % of charges | 1 | $20 | $21 | $4 | 18% | — | $18 – $28 |
| 21 | Thedacare Regional Medical Center-Wild Rose Inc Wild Rose, WI facility · percent of total billed charges · outpatientfrom % of charges | 1 | $19 | $21 | $4 | 18% | — | $18 – $26 |
← Payers reporting HCPCS A9154 · Snapshot 20261111T120946Z-9134e7f7