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
$90
Median
$17
High
$2.0k
Each hospital's average WellCare rate, under the methodology and billing class chosen below.
30 hospitals; the 90th percentile is 6.7× 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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37 hospital rates
iThe hospitals that file a WellCare 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 | Alleghany County Memorial Hospital, Inc Sparta, NC facility · percent of total billed charges · outpatientfrom % of charges | 1 | $113 | $113 | — | — | — | $113 – $113 |
| 2 | Atrium Health Hospitals Inc Kings Mountain, NC percent of total billed charges · outpatientfrom % of charges | 1 | $9 | $9 | — | — | — | $9 – $9 |
| 3 | Atrium Health Hospitals Inc Lincolnton, NC percent of total billed charges · outpatientfrom % of charges | 1 | $7 | $7 | — | — | — | $7 – $7 |
| 4 | Atrium Health Hospitals Inc Wadesboro, NC percent of total billed charges · outpatientfrom % of charges | 1 | $9 | $9 | — | — | — | $9 – $9 |
| 5 | Bristol Regional Medical Center BRISTOL, VA fee schedule · both | 1 | $41 | $41 | — | — | — | $41 – $41 |
| 6 | Bristol Regional Medical Center BRISTOL, VA percent of total billed charges · bothfrom % of charges | 1 | $39 | $39 | — | — | — | $39 – $39 |
| 7 | Carolinas Medical Center Charlotte, NC percent of total billed charges · outpatientfrom % of charges | 1 | $13 | $13 | — | — | — | $13 – $13 |
| 8 | Carolinas Medical Center Charlotte, NC percent of total billed charges · outpatientfrom % of charges | 1 | $13 | $13 | — | — | — | $13 – $13 |
| 9 | Carolinas Medical Center Davidson, NC percent of total billed charges · outpatientfrom % of charges | 1 | $13 | $13 | — | — | — | $13 – $13 |
| 10 | Carolinas Medical Center Charlotte, NC percent of total billed charges · outpatientfrom % of charges | 1 | $13 | $13 | — | — | — | $13 – $13 |
| 11 | Greeneville Community Hospital GREENEVILLE, TN fee schedule · both | 1 | $41 | $41 | — | — | — | $41 – $41 |
| 12 | Greeneville Community Hospital GREENEVILLE, TN percent of total billed charges · bothfrom % of charges | 1 | $39 | $39 | — | — | — | $39 – $39 |
| 13 | Hancock County Hospital SNEEDVILLE, TN percent of total billed charges · bothfrom % of charges | 2 | $32 | $32 | — | — | — | $32 – $32 |
| 14 | Hawkins County Memorial Hospital ROGERSVILLE, TN fee schedule · both | 1 | $41 | $41 | — | — | — | $41 – $41 |
| 15 | Hawkins County Memorial Hospital ROGERSVILLE, TN percent of total billed charges · bothfrom % of charges | 1 | $39 | $39 | — | — | — | $39 – $39 |
| 16 | High Point Regional Health High Point, NC percent of total billed charges · outpatientfrom % of charges | 1 | $15 | $15 | — | — | — | $15 – $15 |
| 17 | Holston Valley Medical Center KINGSPORT, TN fee schedule · both | 1 | $41 | $41 | — | — | — | $41 – $41 |
| 18 | Holston Valley Medical Center KINGSPORT, TN percent of total billed charges · bothfrom % of charges | 1 | $39 | $39 | — | — | — | $39 – $39 |
| 19 | Hoopeston Community Memorial Hospital Hoopeston, IL per diem · inpatient | 1 | $4.0k | $4.0k | — | — | — | $4.0k – $4.0k |
| 20 | Hoopeston Community Memorial Hospital Hoopeston, IL percent of total billed charges · outpatientfrom % of charges | 1 | $5 | $5 | — | — | — | $5 – $5 |
| 21 | Indian Path Community Hospital KINGSPORT, TN fee schedule · both | 1 | $41 | $41 | — | — | — | $41 – $41 |
| 22 | Indian Path Community Hospital KINGSPORT, TN percent of total billed charges · bothfrom % of charges | 1 | $39 | $39 | — | — | — | $39 – $39 |
| 23 | Johnston Memorial Hospital ABINGDON, VA fee schedule · both | 1 | $44 | $44 | — | — | — | $44 – $44 |
| 24 | Lexington Medical Center Lexington, NC percent of total billed charges · outpatientfrom % of charges | 1 | $27 | $27 | — | — | — | $27 – $27 |
| 25 | Lonesome Pine Hospital NORTON, VA fee schedule · both | 1 | $41 | $41 | — | — | — | $41 – $41 |
← Payers reporting HCPCS A9154 · Snapshot 20261111T120946Z-9134e7f7