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Repair Of A Sinus Opening In The Mouth

South Dakota rates for HCPCS D7261

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 July 2026.

How much does Repair Of A Sinus Opening In The Mouth cost?

$309

Typical physician fee. In South Dakota, July 2026.

Insurers have agreed to pay about $309 for this service. Most negotiated rates run $302 to $309.

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 $427 · 10th to 90th $269 to $832Professionalmedian $309 · 10th to 90th $302 to $525
$500$1Kfacility $427professional $309

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. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$269.15
Median
$269.15
Typical High
$269.15
Aetna
Setting
Professional
Modifier
Global
Typical Low
$302.00
Median
$302.00
Typical High
$309.03
Medica
Setting
Facility
Modifier
Global
Typical Low
$338.84
Median
$501.19
Typical High
$831.76
Medica
Setting
Professional
Modifier
Global
Typical Low
$295.12
Median
$398.11
Typical High
$1,905.46
Midlands
Setting
Professional
Modifier
Global
Typical Low
$398.11
Median
$398.11
Typical High
$524.81
Midlands
Setting
Professional
Modifier
Global
Typical Low
$524.81
Median
$524.81
Typical High
$524.81
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$707.95
Median
$707.95
Typical High
$707.95

Where South Dakota sits

The same service costs 7.4 times more in Ohio than in Vermont. 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.

South Dakota· 19th of 51

$309

OH $1,380VT $186

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.