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Single Tooth X-Ray

South Dakota rates for HCPCS D0220

One X-ray image showing a single tooth from crown to root tip along with the surrounding bone, used to look closely at a specific tooth's root, a possible infection, or other localized issue. It is the first image taken in this style; additional images of other teeth are counted separately. It is more focused than a bitewing, which only shows the upper portion of several teeth.

Rates data updated July 2026.

How much does Single Tooth X-Ray cost?

$12.02

Typical negotiated rate. In South Dakota, July 2026.

Insurers have agreed to pay about $12.02 for this service. Most negotiated rates run $12.02 to $13.18.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 4 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $17 · 10th to 90th $11 to $23Professionalmedian $12 · 10th to 90th $11 to $20
$10$20$50facility $17professional $12

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$10.72
Median
$10.72
Typical High
$10.72
Aetna
Setting
Professional
Modifier
Global
Typical Low
$10.47
Median
$12.02
Typical High
$12.59
Medica
Setting
Facility
Modifier
Global
Typical Low
$13.18
Median
$17.78
Typical High
$23.44
Medica
Setting
Professional
Modifier
Global
Typical Low
$12.02
Median
$16.22
Typical High
$75.86
Midlands
Setting
Professional
Modifier
Global
Typical Low
$16.22
Median
$18.62
Typical High
$28.84
Midlands
Setting
Professional
Modifier
Global
Typical Low
$20.42
Median
$20.42
Typical High
$20.42
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$24.55
Median
$24.55
Typical High
$24.55

Where South Dakota sits

The same service costs 4.8 times more in Minnesota than in Vermont. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

South Dakota· 14th of 51

$12.02

MN $38.02VT $7.94

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.