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Utah rates for HCPCS D7220

Removal Of Impacted Tooth - Soft Tissue

Facilitymedian $112 · 10th–90th $112–$1120%50%100%$112Professionalmedian $129 · 10th–90th $112–$2570%20%10th90th$129$50.0$100.0$200.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $112.20 / $112.20
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $128.82 / $257.04
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $44.67 / $194.98
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $177.83 / $177.83
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $194.98 / $204.17