The average cost of wisdom teeth removal with delta dental insurance is approximately $75 for one third molar. However, depending on how impacted the tooth is, it may cost more or it could even cost less. Aside from the severity of impaction there are other factors which can influence your copayment.
Factors affecting wisdom tooth extraction cost:
Severity of impaction
Number of teeth being extracted
Percent coverage
Annual maximum
Deductibles
Provider network status
We will go over all of these potential factors that influence the cost of your wisdom tooth removal with delta dental and how they influence the copay.
Table of Contents:
Average cost of impacted wisdom teeth removal
The precise cost for removing wisdom teeth with delta dental depends on how impacted the teeth are. The more severe the impaction, the greater the price would be. The vice versa is also true in that the less impacted they are, the less it would cost.
Delta dental has categorized the third molars into four types of impaction:
D7210 - surgical extraction of fully erupted wisdom tooth
D7220 - soft tissue impacted wisdom tooth
D7230 - partial bony impacted wisdom tooth
D7240 - full bony impacted wisdom tooth
The table below is what the average cost of extracting a wisdom tooth with delta dental would be if you had 80% insurance coverage.
Type of impacted wisdom tooth | Estimated Average Cost |
|---|---|
Fully erupted (D7210) | $50 |
Soft tissue impacted (D7220) | $75 |
Partial bony impacted (D7230) | $100 |
Full bony impacted (D7240) | $125 |
Fully erupted
The average cost to remove a fully erupted wisdom tooth with delta dental is $50 if you have 80% coverage. You can expect to pay this much if the tooth is fully out and not stuck in the bone nor gums.
Soft tissue impacted
The average cost to remove a soft tissue impacted wisdom tooth with delta dental is $75 if you have 80% coverage. A tooth in this condition is almost fully erupted except there may be a small piece of your gum still covering over it. You should be able to see about 90% or more of the tooth sticking out.
Partial bony impacted
The average cost to remove a partial bony impacted wisdom tooth with delta dental is $100 if you have 80% coverage. A tooth in this condition is characterized by being less than 50% still stuck in the bone and gums. If it is more than 50% then it would be considered fully impacted.
Full bony impacted
The average cost to remove a partial bony impacted wisdom tooth with delta dental is $125 if you have 80% coverage. A tooth in this condition is characterized by being more than 50% still stuck in the bone and gums.
It is interesting to note that the tooth doesn't have to be completely submerged in the bone to qualify as a full impaction. As long as more than 50% of it is not visible to the naked eye would make it qualify.
Delta dental wisdom teeth coverage
Most commonly we see the delta dental wisdom teeth coverage at 80% and that is based on the hundreds of patients at our office. However, we've also seen some plans that can cover more or less but it depends on your specific contract with delta.
Below is an example of an eligibility and benefits check for one of our delta patients. As you can see, the insurance coverage for all four wisdom teeth procedures (D7210, D7220, D7230, D7240) are at 80%. That means the patient's copay would only be 20%.
Just to prove our point, we'll include a benefits breakdown for a different patient with delta dental that has more than 80% coverage. Here, they have 85% wisdom teeth coverage for all four procedure codes. That means they have a 15% copay so they can expect to pay less than the averages which we provided in the previous section.
In summary, the coverage may be more or less but it depends on the plan that you signed up for. Usually when you're choosing a plan you'll be offered low, basic, and high plans. If you choose a plan with better coverage you'll always have a higher monthly insurance premium.
Number of third molars to be extracted
We've provided you with the averages for how much it would cost to remove a single wisdom tooth. You should not forget that most people have FOUR of them in their mouth, located in each quadrant of their mouth.
If you need to get all four of them taken out, you would need to multiply the cost by 4 since there are 4 teeth present. That can certainly increase your out of pocket costs drastically.
Last but not least you should also take into consideration that each of the four teeth can have varying levels of impaction. For example, you can have two partially impacted and two fully impacted. Or if you're lucky, all four of them are fully erupted. Essentially they can come in any combination that you can possibly think of.
Other factors affecting copayment
These factors may increase or decrease the cost of your wisdom tooth removal if you have delta dental. They are typically located in the fine print of your insurance contract so be sure to read it thoroughly. If you have questions, you should call them and ask to be sure.
Annual maximum
Each insurance plan has an annual maximum for the amount of benefits it will pay out each year. If you have a high maximum it will cover what it says it will. Although if you have a low maximum, it may not cover what it states.
Example:
If you have a $1000 annual maximum, your insurance should fully cover the portion that they are meant to pay.
If you have a $500 annual maximum, you may not have enough insurance benefits to fully cover all four wisdom teeth. That may only be enough for two teeth.
The example above is to show you how having a low maximum can increase your copay.
Deductibles
Most dental insurances have an annual deductible which must be paid prior to benefits being disbursed. In other words, the deductible needs to be paid first or met before the insurance will start covering services.
The most common deductible which we see from our delta dental patients is $50. However we've also seen as low as $25 and as high as $100. The amount varies and depends on your insurance plan. Therefore if you have a deductible, it will add to the cost of your extraction.
Provider network status
The network status of your dentist plays a large role in the cost of taking out wisdom teeth. Everything that we've discussed above only applies to seeing a dentist that is in-network with delta dental. Our dentists in Long Island City are a participating provider with delta.
If the dentist that you're seeing is out of network, none of what we spoke about would apply. The average cost of the third molar extraction would be completely different from all of the calculations above. The total copay would most likely be significantly higher than our estimates since your dentist can price it at whatever they want.
Decreasing the delta dental wisdom tooth cost
The only way to decrease your out of pocket costs with delta dental is by choosing a plan with higher coverage.
When you signed up for your insurance, they usually presented to you options for different plan levels. There was probably a low plan, basic plan, and premium plan. The higher the plan level, the higher the coverage would be for the procedures. Of course, the monthly premiums for the insurance would also cost more.
