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South Dakota rates for HCPCS D7241

Removal Of Impacted Tooth - Completely Bony, With Unusual Surgical Complications

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$293.23 / $293.23 / $293.23
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$250.69 / $250.69 / $293.23
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$338.23 / $476.39 / $495.56
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$278.75 / $1,813.11 / $1,813.11
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$357.91 / $530.52 / $1,562.07
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$363.24 / $445.41 / $530.52
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$463.00 / $463.00 / $463.00