go back

Indiana rates for HCPCS D7210

Extraction, Erupted Tooth Requiring Removal Of Bone And/Or Sectioning Of Tooth, And Including Elevation Of Mucoperiosteal Flap If Indicated

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$84.83 / $84.83 / $84.83
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$84.83 / $98.13 / $160.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$130.00 / $130.00 / $250.90
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$130.00 / $130.00 / $184.60
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$109.08 / $141.80 / $174.53
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.08 / $125.44 / $156.56
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$110.69 / $110.69 / $110.69