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Impacted Tooth Removal – Complex Bony Case

Washington rates for HCPCS D7241

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?

$513

Typical negotiated rate. In Washington, October 2026.

Insurers have agreed to pay about $513 for this service. The price depends on where it is billed: about $513 from a physician practice, and about $617 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 7 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$513$457 to $1,820
FacilityA hospital or hospital-owned outpatient department$617$501 to $1,096

How much rates vary

Facilitymedian $617 · 10th to 90th $398 to $9,550Professionalmedian $513 · 10th to 90th $79 to $2,692
$50$200$1K$5K$20Kfacility $617professional $513

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$457.09
Median
$7,943.28
Typical High
$27,542.29
Aetna
Setting
Professional
Modifier
None
Typical Low
$257.04
Median
$457.09
Typical High
$457.09
Asuris Northwest Health
Setting
Facility
Modifier
None
Typical Low
$229.09
Median
$229.09
Typical High
$1,819.70
Asuris Northwest Health
Setting
Professional
Modifier
None
Typical Low
$1,819.70
Median
$2,691.53
Typical High
$2,691.53
Kaiser Permanente
Setting
Professional
Modifier
None
Typical Low
$295.12
Median
$588.84
Typical High
$741.31
Molina
Setting
Professional
Modifier
None
Typical Low
$44.67
Median
$50.12
Typical High
$50.12
Pacific Source
Setting
Facility
Modifier
None
Typical Low
$426.58
Median
$562.34
Typical High
$616.60
Premera BCBS
Setting
Facility
Modifier
None
Typical Low
$489.78
Median
$954.99
Typical High
$1,122.02
Premera BCBS
Setting
Professional
Modifier
None
Typical Low
$512.86
Median
$512.86
Typical High
$512.86
Wellpoint
Setting
Professional
Modifier
None
Typical Low
$331.13
Median
$331.13
Typical High
$331.13

Where Washington 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.

Washington· 12th of 51

$513

TX $1,820VT $178

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.