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Simple Incision Of The Hymen

Kentucky 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 Kentucky, July 2026.

Insurers have agreed to pay about $87.10 for this service. The price depends on where it is billed: about $45.71 from a physician practice, and about $2,089 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$45.71$39.81 to $64.57
FacilityA hospital or hospital-owned outpatient department$2,089$1,413 to $2,818

How much rates vary

Facilitymedian $2,089 · 10th to 90th $851 to $3,890Professionalmedian $46 · 10th to 90th $38 to $112
$50.0$100.0$200.0$500.0$1.0K$2.0K$5.0Kfacility $2,089professional $46

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
$44.67
Median
$1,000.00
Typical High
$8,511.38
Aetna
Setting
Professional
Modifier
Global
Typical Low
$40.74
Median
$45.71
Typical High
$141.25
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,148.15
Median
$2,137.96
Typical High
$2,951.21
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$33.88
Median
$39.81
Typical High
$112.20
CareSource
Setting
Facility
Modifier
Global
Typical Low
$42.66
Median
$60.26
Typical High
$70.79
CareSource
Setting
Professional
Modifier
Global
Typical Low
$43.65
Median
$61.66
Typical High
$72.44
Cigna
Setting
Facility
Modifier
Global
Typical Low
$75.86
Median
$75.86
Typical High
$1,318.26
Cigna
Setting
Professional
Modifier
Global
Typical Low
$50.12
Median
$79.43
Typical High
$239.88
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$32.36
Typical High
$33.11
United
Setting
Facility
Modifier
Global
Typical Low
$602.56
Median
$3,467.37
Typical High
$6,456.54
United
Setting
Professional
Modifier
Global
Typical Low
$40.74
Median
$63.10
Typical High
$93.33

Where Kentucky sits

The same service costs 66.1 times more in California than in West Virginia. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Kentucky $87.10 · 24th of 51
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.