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Impacted Tooth Removal – Soft Tissue Only

South Carolina rates for HCPCS D7220

Surgical removal of a tooth that has not fully erupted but is covered only by gum tissue, not by bone. The gum is opened to expose and remove the tooth, without needing to remove any surrounding jawbone. This is the least involved category of impacted-tooth surgery, though it is still more than a simple extraction of a fully erupted tooth.

Rates data updated October 2026.

How much does Impacted Tooth Removal – Soft Tissue Only cost?

$331

Typical negotiated rate. In South Carolina, October 2026.

Insurers have agreed to pay about $331 for this service. The price depends on where it is billed: about $123 from a physician practice, and about $871 from a hospital or other facility.

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.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$123$120 to $224
FacilityA hospital or hospital-owned outpatient department$871$617 to $1,995

How much rates vary

Facilitymedian $871 · 10th to 90th $468 to $3,802Professionalmedian $123 · 10th to 90th $117 to $224
$100$200$500$1K$2K$5Kfacility $871professional $123

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$123.03
Median
$123.03
Typical High
$123.03
Aetna
Setting
Professional
Modifier
None
Typical Low
$117.49
Median
$123.03
Typical High
$131.83
BCBS South Carolina
Setting
Facility
Modifier
None
Typical Low
$489.78
Median
$870.96
Typical High
$3,890.45
BCBS South Carolina
Setting
Professional
Modifier
None
Typical Low
$120.23
Median
$181.97
Typical High
$223.87
Medcost
Setting
Facility
Modifier
None
Typical Low
$112.20
Median
$134.90
Typical High
$1,995.26
Medcost
Setting
Professional
Modifier
None
Typical Low
$109.65
Median
$109.65
Typical High
$181.97
Molina
Setting
Professional
Modifier
None
Typical Low
$54.95
Median
$54.95
Typical High
$54.95
1 more rate with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
Medcost
Setting
Professional
Modifier
51 · Multiple procedures
Typical Low
$53.70
Median
$54.95
Typical High
$120.23

Where South Carolina sits

The same service costs 7.6 times more in Texas than in West Virginia. 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 Carolina· 7th of 51

$331

TX $676WV $89.13

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.