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Repair Of A Sinus Opening In The Mouth

Virginia 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?

$288

Typical negotiated rate. In Virginia, July 2026.

Insurers have agreed to pay about $288 for this service. The price depends on where it is billed: about $288 from a physician practice, and about $288 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 6 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$288$288 to $417
FacilityA hospital or hospital-owned outpatient department$288$288 to $437

How much rates vary

Facilitymedian $288 · 10th to 90th $245 to $10,000Professionalmedian $288 · 10th to 90th $251 to $490
$200$500$1K$2K$5K$10Kfacility $288professional $288

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
$288.40
Median
$288.40
Typical High
$288.40
Aetna
Setting
Professional
Modifier
Global
Typical Low
$223.87
Median
$288.40
Typical High
$288.40
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$416.87
Median
$416.87
Typical High
$707.95
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$281.84
Median
$354.81
Typical High
$478.63
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$309.03
Median
$371.54
Typical High
$977.24
Medcost
Setting
Facility
Modifier
Global
Typical Low
$223.87
Median
$323.59
Typical High
$524.81
Sentara
Setting
Facility
Modifier
Global
Typical Low
$229.09
Median
$380.19
Typical High
$10,000.00
Sentara
Setting
Professional
Modifier
Global
Typical Low
$223.87
Median
$407.38
Typical High
$10,000.00

Where Virginia 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.

Virginia· 24th of 51

$288

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.