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South Carolina rates for HCPCS D7240

Removal Of Impacted Tooth - Completely Bony

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$191.03 / $4,064.11 / $16,467.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$183.25 / $191.03 / $209.27
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,008.96 / $2,154.98 / $3,868.86
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$170.00 / $202.73 / $405.97
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$171.84 / $210.13 / $342.75
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.00 / $55.00 / $55.00