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Simple Incision Of The Hymen

Massachusetts 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?

$70.79

Typical negotiated rate. In Massachusetts, July 2026.

Insurers have agreed to pay about $70.79 for this service. The price depends on where it is billed: about $58.88 from a physician practice, and about $2,239 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 9 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$50.12 to $102
FacilityA hospital or hospital-owned outpatient department$2,239$1,148 to $3,388

How much rates vary

Facilitymedian $2,239 · 10th to 90th $49 to $5,623Professionalmedian $59 · 10th to 90th $45 to $145
$50$200$1K$5Kfacility $2,239professional $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
$1,000.00
Median
$2,238.72
Typical High
$3,715.35
Aetna
Setting
Professional
Modifier
Global
Typical Low
$40.74
Median
$50.12
Typical High
$141.25
AllWays Health Partners
Setting
Facility
Modifier
Global
Typical Low
$117.49
Median
$4,897.79
Typical High
$19,498.45
AllWays Health Partners
Setting
Professional
Modifier
Global
Typical Low
$40.74
Median
$67.61
Typical High
$204.17
BCBS
Setting
Professional
Modifier
Global
Typical Low
$56.23
Median
$147.91
Typical High
$154.88
Cigna
Setting
Professional
Modifier
Global
Typical Low
$53.70
Median
$83.18
Typical High
$199.53
Fallon Health
Setting
Facility
Modifier
Global
Typical Low
$27.54
Median
$57.54
Typical High
$3,311.31
Fallon Health
Setting
Professional
Modifier
Global
Typical Low
$26.30
Median
$48.98
Typical High
$72.44
Harvard Pilgrim
Setting
Facility
Modifier
Global
Typical Low
$2,041.74
Median
$4,265.80
Typical High
$9,772.37
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$44.67
Median
$81.28
Typical High
$138.04
Health New England
Setting
Facility
Modifier
Global
Typical Low
$4,365.16
Median
$4,365.16
Typical High
$4,365.16
Mass General Brigham
Setting
Facility
Modifier
Global
Typical Low
$117.49
Median
$4,897.79
Typical High
$19,498.45
Mass General Brigham
Setting
Professional
Modifier
Global
Typical Low
$40.74
Median
$67.61
Typical High
$204.17
United
Setting
Facility
Modifier
Global
Typical Low
$1,862.09
Median
$4,265.80
Typical High
$9,772.37
United
Setting
Professional
Modifier
Global
Typical Low
$52.48
Median
$87.10
Typical High
$190.55

Where Massachusetts 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.

Massachusetts· 35th of 51

$70.79

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.