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South Carolina rates for HCPCS D7250

Removal Of Residual Tooth Roots

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$105.90 / $105.90 / $1,488.93
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$105.90 / $105.90 / $115.81
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,057.16 / $2,216.51 / $3,868.86
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.00 / $101.36 / $172.73
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$92.67 / $116.49 / $189.70
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.00 / $55.00 / $55.00