Category: Adult Dentistry, Dr. Advocate's Insight
Are you worried about the cost of wisdom teeth removal? Wisdom teeth surgery is considered a major dental procedure and necessary for most 15 to 25-year-olds. Expect to spend between $200 and $1,100 per tooth! On top of that, you might have to pay another $100-$300 for anesthesia and antibiotics. Consider dental insurance or discount plans so wisdom teeth extractions can be more affordable.
Recommended Reading: Wisdom Teeth | The Ultimate Guide
Calculating the exact cost of wisdom teeth removal relies on many factors. First, verify your dental insurance payment terms. For example, 100/80/50 means they will pay 100% for the preventive procedures, 80% for basic procedures and 50% for major procedures.
If your wisdom teeth have erupted, it would be considered a basic procedure, and you’d likely need to pay 20% of the cost (insurance will pay the remaining 80%). However, if they’re impacted, your insurer probably classifies the procedure as a “major,” and you’d be responsible for paying half the bill.
The cost for erupted teeth can range from $100 – $350 a tooth, and the cost for impacted teeth can range from $175 to $550 a tooth.
The dentist may need to perform an exam, take a panoramic x-ray, other x-rays, or even a cone beam CT (3D imaging). A dental exam is required to evaluate and diagnose the teeth accurately. Often, dental exams are fully covered along with yearly x-rays. Full mouth x-rays are often covered every 1-3 years, and panoramic x-rays every 3-5 years. If a CBCT (cone beam connective tissue) image is required, expect to pay $150 and $750 as most insurances will not cover this procedure.
Cone beam CT images are necessary if wisdom teeth are near vital structures. For example, if lower wisdom teeth are near or within the inferior alveolar nerve (IAN), it’s critical to know how invasive the extraction will be. Proper treatment will prevent damaging the IAN leading to temporary or permanent paresthesia.
In addition, if deep sedation is required, expect to pay $50 to $225 depending on the length and type of anesthesia. Sedation fees are calculated in 15-minute intervals.
Recommended Reading: Wisdom Teeth Removal (What’s Involved?)
Most dental insurance plans don’t cover the total cost of tooth extractions and other major procedures. Instead, you’ll typically pay a portion of the total price, with the insurance plan picking up the rest. With so many insurance plans available, it’s essential to understand the significant differences between them. Consider these differences.
Recommended Reading: Sedation Options for Wisdom Teeth Removal (Read this FIRST)
Too often, patients present to the office thinking their insurance is active when it's not. They mistakenly forgot to re-enroll, or their HR department dropped the ball. Verify your insurance plan is active and willing to cover the procedure.
Most dental insurances require a 60-90 day waiting period before they are willing to cover the cost of procedures. Find out if your insurance has a waiting period and, if so, how long. It's more common to see a waiting period for major services compared to preventative services.
Waiting periods on dental plans are designed to prevent patients from taking advantage of their coverage. In addition, waiting periods help dental insurance companies stay profitable by collecting premiums before they have to start paying for expensive procedures.
In-network dentists are contracted with your dental insurance plan and can offer discounted rates for their services. Out-of-network dentists are not contracted with your dentist and will not offer discounted rates. However, most dental insurance companies will have a "find a provider" link on their website to verify contracted dentists.
Verifying that the oral surgeon referral is in-network with your insurance is essential. In addition, verify with your insurance plan before treatment, so you're not stuck with a bill if they are not contracted.
How much you pay depends on the details of your dental insurance policy. For example, if your plan has 100/80/50 terms, your insurance will cover 100% of preventive care, 80% of basic procedures, and 50% of major procedures.
Most dental insurance plans also have an annual maximum. So, if you're getting all four teeth removed with general anesthesia, the cost of the procedure may exceed your annual maximum limit. You'd then be responsible for paying 100% of each dollar over your maximum.
Medicaid usually covers wisdom teeth extractions for children and teens; however, some states also offer coverage for adult patients. In addition, some Medicare Advantage health insurance policies include dental benefits that may pay for wisdom teeth removal. Call your state Medicaid office directly to find out if your state Medicaid plan covers the cost of a wisdom teeth extraction for an adult patient.
The cost for erupted teeth can range from $200 to $700 a tooth, and the cost for impacted teeth can range from $350 to $1,100 a tooth.
In addition, the dentist may need to perform an exam, take a panoramic x-ray, other x-rays, or even a cone beam CT (3D imaging). Most dental exams cost $50 to $200 for the dentist to thoroughly review your wisdom teeth removal needs. In addition, panoramic x-rays cost $100 to $250, periapical x-rays cost $25 and $50 and cone beam CTs cost $150 and $750.
If general anesthesia is required, expect to pay $100 to $450 depending on the length and type of anesthesia. Sedation fees are calculated in 15-minute intervals.
Recommended Reading: Impacted Wisdom Teeth: Symptoms, Causes, Removal & Recovery
The costs of wisdom tooth removal can be high. However, aside from finding an in-network provider, there are other ways to save on wisdom teeth removal.
Dental plans with no waiting periods are valuable because they allow patients to immediately get coverage for preventive, basic, and major services—and sometimes even orthodontics. These plans are ideal for patients who cannot purchase insurance due to cost or who need to undergo a major dental procedure.
The best dental plans with no waiting period have low monthly premiums, high annual coverage limits, and a comprehensive network of in-network dentists.
Humana has no waiting periods for four of its seven dental insurance policies. In addition, the choices and benefits offered by these policies are among the best in the industry, including a PPO policy, an HMO policy, and a dental discount policy with some of the lowest premium costs. Humana’s Preventive Value Individual and Dental Loyalty Plus plan provide PPO coverage. Preventive Value Individual is best for those who need only preventive and basic services, while Dental Loyalty Plus adds major service coverage. In addition, both plans pay for 100% of preventive services.
Humana’s Dental Value HMO plan has no deductible or annual maximum. Humana also offers a Dental Savings Plus discount plan that costs $6.99 monthly. This plan provides 20% to 40% discounts when you visit one of the 160,000 in-network dentists. In addition, this plan includes a 20% discount on orthodontics.
UnitedHealthcare is an excellent choice if you want insurance to cover preventive and basic services and don’t want to wait six months to a year for the policy to take effect. Seven of the provider’s ten dental plans have no waiting period for preventive and basic services. But, unfortunately, most cover major services after a six-month wait.
MetLife is a global insurance provider offering insurance in many lines and has been doing business since 1868.
MetLife requires waiting periods for most of its policies. The standard plan has a $50 deductible, and annual maximums range from $1,000 to $3,500, depending on the plan. For in-network dentists, the plans cover 100% of preventive care, 50% to 70% of basic services, and 30% to 50% of major services.
Delta Dental is a significant provider of dental services, serving more than 80 million Americans and maintaining a wide range of dental insurance options. By focusing exclusively on providing dental care, Delta Dental can provide its clients lower prices than most competing companies. Delta Dental offers only one policy with no waiting periods and a low monthly premium; the HMO plan is named DeltaCare USA. Copays are listed by procedure and are relatively reasonable; you’ll pay only $20 out of pocket for cleanings and exams. X-rays are free of charge, fillings cost $25 to $120, and root canals cost $240 to $400. There are no deductibles or annual maximums.
Too often, patients present to the office thinking their insurance is active when it's not. They mistakenly forgot to re-enroll, or their HR department dropped the ball. Verify your insurance plan is active and willing to cover the procedure.
Most dental insurances require a 60-90 day waiting period before they are willing to cover the cost of procedures. Find out if your insurance has a waiting period and, if so, how long. It's more common to see a waiting period for major services compared to preventative services.
Waiting periods on dental plans are designed to prevent patients from taking advantage of their coverage. In addition, waiting periods help dental insurance companies stay profitable by collecting premiums before they have to start paying for expensive procedures.
In-network dentists are contracted with your dental insurance plan and can offer discounted rates for their services. Out-of-network dentists are not contracted with your dentist and will not offer discounted rates. However, most dental insurance companies will have a "find a provider" link on their website to verify contracted dentists.
Verifying that the oral surgeon referral is in-network with your insurance is essential. In addition, verify with your insurance plan before treatment, so you're not stuck with a bill if they are not contracted.
How much you pay depends on the details of your dental insurance policy. For example, if your plan has 100/80/50 terms, your insurance will cover 100% of preventive care, 80% of basic procedures, and 50% of major procedures.
Most dental insurance plans also have an annual maximum. So, if you're getting all four teeth removed with general anesthesia, the cost of the procedure may exceed your annual maximum limit. You'd then be responsible for paying 100% of each dollar over your maximum.
Medicaid usually covers wisdom teeth extractions for children and teens; however, some states also offer coverage for adult patients. In addition, some Medicare Advantage health insurance policies include dental benefits that may pay for wisdom teeth removal. Call your state Medicaid office directly to find out if your state Medicaid plan covers the cost of a wisdom teeth extraction for an adult patient.
Understanding the cost of wisdom teeth removal will help alleviate anxiety. Although the procedure is a significant expense, removing third molars is essential before they become problematic.