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Indiana rates for HCPCS D7220

Removal Of Impacted Tooth - Soft Tissue

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$97.72 / $97.72 / $97.72
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.72 / $113.22 / $195.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$163.00 / $163.00 / $314.58
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$163.00 / $163.00 / $231.46
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$139.03 / $139.03 / $139.03