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Simple Incision Of The Hymen

New Jersey 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?

$60.26

Typical negotiated rate. In New Jersey, July 2026.

Insurers have agreed to pay about $60.26 for this service. The price depends on where it is billed: about $50.12 from a physician practice, and about $6,026 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 5 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$50.12$43.65 to $81.28
FacilityA hospital or hospital-owned outpatient department$6,026$4,365 to $8,511

How much rates vary

Facilitymedian $6,026 · 10th to 90th $2,344 to $10,965Professionalmedian $50 · 10th to 90th $41 to $3,548
$50.0$200.0$1.0K$5.0K$20.0Kfacility $6,026professional $50

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
$2,290.87
Median
$5,888.44
Typical High
$10,964.78
Aetna
Setting
Professional
Modifier
Global
Typical Low
$40.74
Median
$50.12
Typical High
$5,370.32
Cigna
Setting
Professional
Modifier
Global
Typical Low
$45.71
Median
$72.44
Typical High
$234.42
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$46.77
Median
$63.10
Typical High
$83.18
Horizon BCBS
Setting
Facility
Modifier
Global
Typical Low
$6,606.93
Median
$11,481.54
Typical High
$16,218.10
Horizon BCBS
Setting
Professional
Modifier
Global
Typical Low
$38.90
Median
$53.70
Typical High
$120.23
United
Setting
Facility
Modifier
Global
Typical Low
$2,511.89
Median
$6,165.95
Typical High
$10,964.78
United
Setting
Professional
Modifier
Global
Typical Low
$40.74
Median
$61.66
Typical High
$95.50

Where New Jersey 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.

New Jersey $60.26 · 43rd 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.