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Simple Incision Of The Hymen

New York 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?

$138

Typical negotiated rate. In New York, July 2026.

Insurers have agreed to pay about $138 for this service. The price depends on where it is billed: about $58.88 from a physician practice, and about $4,074 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$44.67 to $87.10
FacilityA hospital or hospital-owned outpatient department$4,074$2,630 to $6,166

How much rates vary

Facilitymedian $4,074 · 10th to 90th $83 to $8,913Professionalmedian $59 · 10th to 90th $41 to $158
$100.0$1.0K$10.0Kfacility $4,074professional $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
$60.26
Median
$3,090.30
Typical High
$7,762.47
Aetna
Setting
Professional
Modifier
Global
Typical Low
$40.74
Median
$58.88
Typical High
$177.83
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$2,630.27
Median
$4,786.30
Typical High
$9,120.11
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$38.02
Median
$48.98
Typical High
$125.89
CDPHP
Setting
Facility
Modifier
Global
Typical Low
$66.07
Median
$1,258.93
Typical High
$4,073.80
CDPHP
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$66.07
Typical High
$66.07
Cigna
Setting
Facility
Modifier
Global
Typical Low
$75.86
Median
$75.86
Typical High
$3,801.89
Cigna
Setting
Professional
Modifier
Global
Typical Low
$47.86
Median
$102.33
Typical High
$245.47
Emblem Health
Setting
Facility
Modifier
Global
Typical Low
$52.48
Median
$75.86
Typical High
$169.82
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$46.77
Median
$63.10
Typical High
$89.13
Excellus BCBS
Setting
Professional
Modifier
Global
Typical Low
$41.69
Median
$61.66
Typical High
$100.00
MVP Health Care
Setting
Facility
Modifier
Global
Typical Low
$52.48
Median
$50,118.72
Typical High
$75,857.76
MVP Health Care
Setting
Professional
Modifier
Global
Typical Low
$56.23
Median
$72.44
Typical High
$162.18
United
Setting
Facility
Modifier
Global
Typical Low
$2,137.96
Median
$3,981.07
Typical High
$9,332.54
United
Setting
Professional
Modifier
Global
Typical Low
$46.77
Median
$70.79
Typical High
$162.18
Univera
Setting
Facility
Modifier
Global
Typical Low
$38.90
Median
$53.70
Typical High
$144.54
Univera
Setting
Professional
Modifier
Global
Typical Low
$38.90
Median
$57.54
Typical High
$120.23

Where New York 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 York $138 · 10th 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.