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Simple Incision Of The Hymen

Illinois rates for HCPCS 56442

This minor procedure makes a small incision to open the hymen, the thin tissue that partially covers the entrance to the vagina. It is done to relieve a blockage that is preventing normal menstrual flow or causing pain, or for other medical reasons requiring the opening to be enlarged. It is typically a quick procedure done under local or light anesthesia.

Rates data updated July 2026.

How much does Simple Incision Of The Hymen cost?

$87.10

Typical negotiated rate. In Illinois, July 2026.

Insurers have agreed to pay about $87.10 for this service. The price depends on where it is billed: about $58.88 from a physician practice, and about $1,862 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$58.88$46.77 to $87.10
FacilityA hospital or hospital-owned outpatient department$1,862$851 to $3,890

How much rates vary

Facilitymedian $1,862 · 10th to 90th $87 to $5,623Professionalmedian $59 · 10th to 90th $42 to $138
$50$200$1K$5Kfacility $1,862professional $59

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
$87.10
Median
$1,445.44
Typical High
$5,623.41
Aetna
Setting
Professional
Modifier
Global
Typical Low
$40.74
Median
$54.95
Typical High
$125.89
BCBS
Setting
Facility
Modifier
Global
Typical Low
$537.03
Median
$4,168.69
Typical High
$5,495.41
BCBS
Setting
Professional
Modifier
Global
Typical Low
$57.54
Median
$77.62
Typical High
$85.11
Cigna
Setting
Professional
Modifier
Global
Typical Low
$46.77
Median
$69.18
Typical High
$138.04
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$87.10
Typical High
$309.03
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$56.23
Median
$60.26
Typical High
$67.61
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$33.11
United
Setting
Facility
Modifier
Global
Typical Low
$1,819.70
Median
$3,388.44
Typical High
$7,585.78
United
Setting
Professional
Modifier
Global
Typical Low
$46.77
Median
$63.10
Typical High
$104.71

Where Illinois sits

The same service costs 66.1 times more in California than in West Virginia. 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.

Illinois· 23rd of 51

$87.10

CA $3,020WV $45.71

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.