In California, insurers have negotiated a median of $145 to remove an erupted wisdom tooth and $344 for a tooth buried in bone. Four wisdom teeth with IV sedation and an X-ray come to about $1,575 before insurance. On two real California Delta Dental plans, the patient paid $338 of that bill on one and $664 on the other. If you have no insurance, budget closer to the US cash averages of $2,685 for four teeth and $3,340 for four impacted teeth.
Your bill depends on how deep each tooth sits in the jaw. At California in-network rates, that runs from $145 for an erupted tooth to $462 for a complicated bony impaction, plus X-ray and sedation fees. We took those rates from federal price-transparency files refreshed in March 2026, and we use them to price treatment for patients of our Carmel Mountain Ranch dentists.
Price per wisdom tooth by impaction type
An erupted wisdom tooth costs the least to remove and a tooth fully buried in bone costs the most. The American Dental Association gives each level of difficulty its own CDT procedure code, and each code carries its own fee. Your panoramic X-ray decides which code applies before anyone quotes you a price.
You’ll see two kinds of price. The in-network rate is what an insurer has agreed to pay a dentist for a code, published under the federal Transparency in Coverage rule. The cash price is what practices charge patients paying on their own, and CareCredit’s 2024 US data gives the averages. Here are the California in-network medians from the March 2026 refresh, with US cash averages where CareCredit reports them:
- Erupted tooth, simple extraction (D7140): $145 in-network, $177 cash.
- Erupted tooth that needs bone removal or sectioning (D7210): no published California rate, and $363 cash for a surgical extraction.
- Partly erupted tooth covered by gum, a soft-tissue impaction (D7220): $224 in-network, $423 cash.
- Tooth partly covered by bone, a partial bony impaction (D7230): $238 in-network.
- Tooth fully covered by bone, a complete bony impaction (D7240): $344 in-network, $532 cash.
- Complete bony impaction with unusual surgical complications (D7241): $462 in-network, and $835 cash for a complicated impacted tooth.
Cash figures run higher because practices set them as list prices, while insurers negotiate theirs down. For all four teeth, CareCredit’s US averages are $2,685, or $3,340 when all four are impacted.
Lower wisdom teeth land in the higher tiers more often than upper ones. The lower jawbone is denser, and the teeth tend to sit at an angle against the second molar. So a San Diego quote for four teeth lists four separate codes, often two cheap and two expensive. At your consultation, our team breaks the cost down tooth by tooth.
Sedation and imaging fees on top of the extraction
Sedation adds the most to a wisdom teeth bill, and the X-ray comes second. Bone removal is already part of the impaction code. The extraction fee also covers the local anaesthetic, because dentists only bill its separate code (D9210) when they give it without a procedure.
The panoramic X-ray (D0330) shows all four third molars and the nerve canal in one image, and has a California in-network median of $86. Most PPO plans pay for diagnostic X-rays in full. If you come to us in pain from a swollen wisdom tooth, you get a free emergency exam and X-rays, so that line drops off your bill.
Dentists bill sedation by type and by time. The California in-network medians are:
- Nitrous oxide (D9230): $55 per visit.
- IV moderate sedation: $119 for the first 15 minutes (D9239), then $117 for each extra 15 minutes (D9243). A 45-minute appointment comes to $353, and an hour comes to $470.
- Deep sedation or general anaesthesia: $123 for each 15 minutes after the first (D9223), usually at an oral surgeon’s office.
On a cash basis, CareCredit’s 2024 US averages put dental sedation at $349 and general anaesthesia at $639.
Bone removal and sectioning are what move a tooth from D7140 to D7210, or from D7220 to D7240. If a quote lists “bone removal” as its own line next to an impaction code, ask about it, because the code already includes that work. We offer nitrous, oral and IV sedation, and our monitored sedation options page explains each one. If you choose oral or IV sedation, you’ll need someone to drive you home.
What PPO insurance usually pays and how the deductible works
Most PPO plans pay 100% of the exam and X-ray. After the deductible, they pay either 80% or 50% of the extraction, depending on whether your plan files oral surgery as a basic or a major service. You’ll see that split between two Delta Dental plans sold in California:
- Delta Dental of California’s 2025 employer PPO summary for Placer County staff lists oral surgery under basic services at 80%.
- The 2026 Covered California Delta Dental PPO Family Dental plan lists extractions under major services at 50%. Adults face a $50 deductible, a $1,500 annual maximum and a 6-month waiting period for major services. The plan puts IV sedation and general anaesthesia under basic services when you receive them for covered oral surgery.
The deductible is what you pay before the plan starts sharing costs, usually once per benefit year. The annual maximum is the most the plan will pay in that year.
Those maximums have stayed flat for a long time. “These caps, often unchanged for decades, restrict how much the plan will pay per year,” said Dr. Bert Hughes, vice chair of the ADA Council on Dental Benefit Programs, in ADA News in December 2025. The same article cites National Association of Dental Plans data showing 32.8% of in-network maximums fall between $1,000 and $1,500.
Say you need two lower teeth out of the bone (D7240) and two upper teeth out from under the gum (D7220), with 45 minutes of IV sedation and a panoramic X-ray. At the California medians above, that comes to $1,575.
On the 80% employer plan, the plan pays the $86 X-ray in full. It then pays 80% of the remaining $1,489 once you’ve covered the $50 deductible. The plan pays $1,237.20 and you pay $337.80.
On the Covered California plan, the X-ray costs you nothing. The plan pays 50% of the extractions after the deductible and 80% of the sedation, so it pays $911.40 and you pay $663.60. Both plans carry the Delta Dental name, and you’d pay almost twice as much on the second one for the same four teeth.
Using 2026 benefits before they reset on 1 January
If your plan runs on the calendar year, your 2026 deductible and annual maximum end on 31 December, and unused benefits don’t roll over. Treatment you book by then uses money the plan already owes you. Delta Dental of Arkansas, for example, defines the calendar-year benefit period as 1 January to 31 December, with the deductible and maximum resetting on 1 January.
Some plans reset at other times. Policy-year plans reset on the anniversary of the start date, and the Covered California plan above runs on a contract year that starts on your effective date. Check the benefit period on your plan summary first.
Your best move depends on how much of your maximum you have left. In the worked example, the 80% plan’s share is $1,237.20. Suppose a crown earlier in 2026 already used $900 of your $1,500 maximum, leaving $600. Book in December and you pay $975. Book in January with a fresh maximum and you pay $337.80, a saving of $637.20.
Book in 2026 if your remaining maximum covers the plan’s share and you’ve met the deductible. If you’ve almost used up the maximum, wait for January. You’d have plenty of company: a CareQuest Institute survey published in February 2026 found that 39% of adults who reached their maximum delayed or stopped care until their benefits renewed.
Only wait if the tooth is quiet. A partly erupted wisdom tooth that traps food can cause decay on the second molar and gum pockets behind it, and either problem means more treatment and a bigger bill. Swelling, fever or pain when you open wide are signs of a true dental emergency, and you should get seen now rather than in January.
Flexible spending accounts have their own deadline. The IRS set the 2026 health FSA limit at $3,400, and your employer can let you carry up to $680 into the next plan year (Rev. Proc. 2025-32). IRS Publication 502 lists extractions as a qualifying dental expense, so you can pay for wisdom teeth removal with FSA or HSA money. Spend the FSA money before the deadline, because anything above the carryover is gone.
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Monthly payment plans if you have no insurance
Without insurance, you pay the practice’s fee for each code, and a healthcare financing plan can spread that bill into monthly payments. How the plan charges interest matters more than which lender offers it. Smiles By Design accepts most insurance plans and offers special discounts and financing options, and our front desk can tell you which payment plan fits your estimate.
Most California dental offices work with two lenders, and they handle interest in different ways.
CareCredit is a healthcare credit card issued by Synchrony Bank. It offers no-interest promotions of 6, 12, 18 or 24 months on purchases of $200 or more, but the interest is deferred. If you still owe anything when the promotion ends, CareCredit charges interest back to the original purchase date at its standard 32.99% APR (NerdWallet, June 2026). It also offers fixed monthly plans at lower rates, such as 17.90% APR over 24 months.
Cherry is a point-of-sale lender. Its site lists loans from $35 to $65,000 over 1 to 60 months at 0% to 35.99% APR, with a soft credit check, and says its 0% plans carry no deferred interest. Those are Cherry’s own published terms, and your rate depends on approval.
Deferred interest catches a lot of people out. The Consumer Financial Protection Bureau’s May 2023 report on medical credit cards found that patients paid about $1 billion in deferred interest on healthcare purchases from 2018 to 2020. Lenders charged interest on about 20% of those purchases, and those borrowers paid interest equal to about 23% of the original bill. On a $3,340 bill for four impacted teeth, 23% is about $768.
Pick the plan by the monthly payment you can afford. To clear $3,340 inside a 12-month promotion, you’d pay $278.33 a month. If that’s too much, a fixed-rate plan with a set monthly amount will cost you less than a deferred-interest promotion you can’t finish in time.
When we refer to an oral surgeon and what that changes
We refer you to an oral and maxillofacial surgeon if the roots sit on the nerve canal, if you need deep sedation or general anaesthesia, or if your medical history calls for a surgical setting. A referral changes who bills you, how they price sedation and which network rules apply. Dr. Javaheri removes wisdom teeth in our office when the X-ray shows the tooth suits in-office removal.
According to the American Association of Oral and Maxillofacial Surgeons, oral and maxillofacial surgeons train for four to six years in a hospital-based surgical residency that includes anaesthesia. In California, a dentist giving deep sedation or general anaesthesia also needs a General Anesthesia permit from the Dental Board of California, under rules that took effect on 1 January 2022.
On your bill, a referral can change these lines:
- The code often moves up. A complicated complete bony impaction (D7241) has a California in-network median of $462, against $344 for a standard one.
- Sedation moves to deep sedation or general anaesthesia, at a median $123 for each 15 minutes after the first.
- The surgeon’s office gives you its own estimate, and network status sets your coinsurance. On the Covered California plan, you pay 20% for basic services in-network and 30% out-of-network.
Network status is where referrals catch patients out. A Delta Dental PPO summary for California public employees states that “out-of-network dentists may bill the difference between their usual fee and Delta Dental’s maximum.” Before you book, ask the surgeon’s office whether it’s in network with your plan. Ask too whether it will accept the panoramic X-ray you already have, so you don’t pay $86 twice.
Check your plan before you book
The same four teeth cost $1,575 at California in-network rates. One Delta Dental member paid $338 of that and another paid $664, because one plan files extractions as basic and the other as major. Before 31 December, find out which category your plan uses and how much of your maximum you have left. Those two numbers tell you whether to book in 2026 or wait for January.
Bring your plan details and we’ll price your extraction code by code. Book a complimentary consultation with Smiles By Design Dentistry in Carmel Mountain Ranch, or call (858) 485-5552.
FAQs About Wisdom Tooth Extraction Cost
How much does it cost to remove all four wisdom teeth in San Diego?
At California in-network rates in March 2026, removing all four wisdom teeth costs about $1,575 before insurance. That covers two bony and two soft-tissue impactions, 45 minutes of IV sedation and an X-ray. Without insurance, CareCredit’s 2024 US averages are $2,685 for four teeth and $3,340 for four impacted teeth.
Does dental insurance cover wisdom teeth removal for teenagers?
Most family PPO plans cover wisdom teeth removal for teenagers, and children’s coverage is often better than adults’. The 2026 Covered California Delta Dental PPO Family Dental plan has no annual maximum and no waiting period for children under 19. AAOMS places the arrival of wisdom teeth between ages 17 and 25.
Can I use my FSA or HSA for wisdom teeth removal?
Yes. IRS Publication 502 lists extractions as a qualifying dental expense. For 2026 the health FSA limit is $3,400, and your employer can let you carry over up to $680. HSA balances roll over every year with no deadline.
Is there a waiting period before insurance covers wisdom teeth removal?
Some plans make adults wait, especially plans that file extractions as major services. The 2026 Covered California Delta Dental PPO Family Dental plan applies a 6-month waiting period for adults 19 and older, and waives it if you can show prior coverage. Employer group plans often have no waiting period.
