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South Dakota rates for HCPCS D7220

Removal Of Impacted Tooth - Soft Tissue

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$128.82 / $134.90 / $134.90
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.15 / $128.82 / $141.25
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$147.91 / $199.53 / $331.13
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.82 / $295.12 / $851.14
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$204.17 / $234.42 / $295.12
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$234.42 / $234.42 / $234.42
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$269.15 / $269.15 / $269.15