Surgical removal of a tooth that is completely encased in jawbone, in a case that involves added surgical difficulty, for example the tooth's position near a nerve or sinus, an unusual root shape, or other complicating anatomy. It requires the same bone and gum access as a standard fully bony impaction, plus extra surgical steps to safely manage the complication. It is used only when those added factors are actually present, not for routine fully bony extractions.
Rates data updated October 2026.
How much does Impacted Tooth Removal – Complex Bony Case cost?
$457
Typical negotiated rate. In South Carolina, October 2026.
Insurers have agreed to pay about $457 for this service. The price depends on where it is billed: about $263 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 by
Who charges it
Typical
Range
Physician practiceA doctor's office, clinic or independent provider
A doctor's office, clinic or independent provider
$263
$214 to $457
FacilityA hospital or hospital-owned outpatient department
A hospital or hospital-owned outpatient department
$871
$617 to $2,089
How much rates vary
Facilitymedian $871 · 10th to 90th $468 to $3,890Professionalmedian $263 · 10th to 90th $214 to $457
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
Facility/Professional
Modifier
Typical LowTypical Low is the 10th percentile of the published rates, Median the 50th, and Typical High the 90th. One in ten rates falls below Typical Low, and one in ten falls above Typical High.
MedianTypical Low is the 10th percentile of the published rates, Median the 50th, and Typical High the 90th. One in ten rates falls below Typical Low, and one in ten falls above Typical High.
Typical HighTypical Low is the 10th percentile of the published rates, Median the 50th, and Typical High the 90th. One in ten rates falls below Typical Low, and one in ten falls above Typical High.
Aetna
Setting
Facility
Modifier
None
Typical Low
$263.03
Median
$9,120.11
Typical High
$22,908.68
Facility
None
$263.03
$9,120.11
$22,908.68
Aetna
Setting
Professional
Modifier
None
Typical Low
$251.19
Median
$263.03
Typical High
$281.84
Professional
None
$251.19
$263.03
$281.84
BCBS South Carolina
Setting
Facility
Modifier
None
Typical Low
$489.78
Median
$870.96
Typical High
$3,890.45
Facility
None
$489.78
$870.96
$3,890.45
BCBS South Carolina
Setting
Professional
Modifier
None
Typical Low
$213.80
Median
$323.59
Typical High
$457.09
Professional
None
$213.80
$323.59
$457.09
Medcost
Setting
Facility
Modifier
None
Typical Low
$223.87
Median
$288.40
Typical High
$1,995.26
Facility
None
$223.87
$288.40
$1,995.26
Medcost
Setting
Professional
Modifier
None
Typical Low
$213.80
Median
$213.80
Typical High
$380.19
Professional
None
$213.80
$213.80
$380.19
Molina
Setting
Professional
Modifier
None
Typical Low
$54.95
Median
$54.95
Typical High
$54.95
Professional
None
$54.95
$54.95
$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
Facility/Professional
Modifier
Typical LowTypical Low is the 10th percentile of the published rates, Median the 50th, and Typical High the 90th. One in ten rates falls below Typical Low, and one in ten falls above Typical High.
MedianTypical Low is the 10th percentile of the published rates, Median the 50th, and Typical High the 90th. One in ten rates falls below Typical Low, and one in ten falls above Typical High.
Typical HighTypical Low is the 10th percentile of the published rates, Median the 50th, and Typical High the 90th. One in ten rates falls below Typical Low, and one in ten falls above Typical High.
Medcost
Setting
Professional
Modifier
51 · Multiple procedures
Typical Low
$107.15
Median
$107.15
Typical High
$239.88
Professional
51 · Multiple procedures
$107.15
$107.15
$239.88
Where South Carolina sits
The same service costs 10.2 times more in Texas than in Vermont. 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.