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Closure of Mouth-Sinus Opening

Pennsylvania rates for HCPCS D7260

Surgery to close an abnormal opening that has formed between the mouth and the sinus above the upper back teeth. This connection can develop after an upper tooth is removed or from a long-standing infection, and closing it prevents food, liquid, and bacteria from passing between the mouth and sinus.

Rates data updated July 2026.

How much does Closure of Mouth-Sinus Opening cost?

$389

Typical negotiated rate. In Pennsylvania, July 2026.

Insurers have agreed to pay about $389 for this service. The price depends on where it is billed: about $389 from a physician practice, and about $389 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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 5 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$389$347 to $589
FacilityA hospital or hospital-owned outpatient department$389$389 to $389

How much rates vary

Facilitymedian $389 · 10th to 90th $389 to $389Professionalmedian $389 · 10th to 90th $331 to $692
$500$1K$2K$5K$10K$20K$50Kfacility $389professional $389

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$389.05
Median
$389.05
Typical High
$389.05
Aetna
Setting
Professional
Modifier
Global
Typical Low
$331.13
Median
$389.05
Typical High
$630.96
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$5,011.87
Median
$8,511.38
Typical High
$77,624.71
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$851.14
Median
$870.96
Typical High
$870.96
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$616.60
Median
$616.60
Typical High
$616.60
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$389.05
Median
$389.05
Typical High
$389.05
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$331.13
Median
$363.08
Typical High
$630.96
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$1,230.27
Median
$1,230.27
Typical High
$1,258.93

Where Pennsylvania sits

The same service costs 11.5 times more in Minnesota than in Nebraska. 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.

Pennsylvania· 35th of 51

$389

MN $3,090NE $269

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.