Surgical closure of an unwanted opening between the mouth and the sinus above the upper back teeth, which can occur after an upper tooth is removed or from other trauma near that area. The gum tissue is repositioned and stitched to seal the opening and prevent food, liquid, or air from passing between the mouth and sinus. It's typically done at the time the opening is discovered, often right after the extraction that caused it.
Rates data updated October 2026.
How much does Repair Of A Sinus Opening In The Mouth cost?
$490
Typical physician fee. In North Carolina, October 2026.
Insurers have agreed to pay about $490 for this service. Most negotiated rates run $302 to $603.
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 4 insurance carriers under federal price transparency rules.
How much rates vary
Facilitymedian $302 · 10th to 90th $302 to $479Professionalmedian $501 · 10th to 90th $257 to $661
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
Insurance Carrier
Facility/Professional
Modifier
Typical LowTypical Low is the 10th percentile of the published rates, Median the 50th, and Typical High the 90th. One in ten rates falls below Typical Low, and one in ten falls above Typical High.
MedianTypical Low is the 10th percentile of the published rates, Median the 50th, and Typical High the 90th. One in ten rates falls below Typical Low, and one in ten falls above Typical High.
Typical HighTypical Low is the 10th percentile of the published rates, Median the 50th, and Typical High the 90th. One in ten rates falls below Typical Low, and one in ten falls above Typical High.
Aetna
Setting
Facility
Modifier
None
Typical Low
$302.00
Median
$302.00
Typical High
$302.00
Facility
None
$302.00
$302.00
$302.00
Aetna
Setting
Professional
Modifier
None
Typical Low
$257.04
Median
$302.00
Typical High
$302.00
Professional
None
$257.04
$302.00
$302.00
BCBS North Carolina
Setting
Professional
Modifier
None
Typical Low
$295.12
Median
$537.03
Typical High
$691.83
Professional
None
$295.12
$537.03
$691.83
Medcost
Setting
Facility
Modifier
None
Typical Low
$302.00
Median
$354.81
Typical High
$524.81
Facility
None
$302.00
$354.81
$524.81
Medcost
Setting
Professional
Modifier
None
Typical Low
$229.09
Median
$257.04
Typical High
$512.86
Professional
None
$229.09
$257.04
$512.86
United
Setting
Professional
Modifier
None
Typical Low
$269.15
Median
$338.84
Typical High
$398.11
Professional
None
$269.15
$338.84
$398.11
1 more rate with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
Insurance Carrier
Facility/Professional
Modifier
Typical LowTypical Low is the 10th percentile of the published rates, Median the 50th, and Typical High the 90th. One in ten rates falls below Typical Low, and one in ten falls above Typical High.
MedianTypical Low is the 10th percentile of the published rates, Median the 50th, and Typical High the 90th. One in ten rates falls below Typical Low, and one in ten falls above Typical High.
Typical HighTypical Low is the 10th percentile of the published rates, Median the 50th, and Typical High the 90th. One in ten rates falls below Typical Low, and one in ten falls above Typical High.
Medcost
Setting
Professional
Modifier
51 · Multiple procedures
Typical Low
$114.82
Median
$128.82
Typical High
$389.05
Professional
51 · Multiple procedures
$114.82
$128.82
$389.05
Where North Carolina sits
The same service costs 12.3 times more in Texas than in New Jersey. 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.