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Simple Incision Of The Hymen

Virginia 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?

$64.57

Typical negotiated rate. In Virginia, July 2026.

Insurers have agreed to pay about $64.57 for this service. The price depends on where it is billed: about $54.95 from a physician practice, and about $2,570 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 8 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$54.95$45.71 to $79.43
FacilityA hospital or hospital-owned outpatient department$2,570$69.18 to $5,370

How much rates vary

Facilitymedian $2,570 · 10th to 90th $51 to $8,913Professionalmedian $55 · 10th to 90th $40 to $2,042
$50.0$200.0$1.0K$5.0Kfacility $2,570professional $55

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
$52.48
Median
$3,235.94
Typical High
$8,912.51
Aetna
Setting
Professional
Modifier
Global
Typical Low
$39.81
Median
$52.48
Typical High
$2,818.38
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$3,090.30
Median
$3,981.07
Typical High
$4,466.84
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$45.71
Median
$60.26
Typical High
$87.10
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$52.48
Median
$74.13
Typical High
$3,548.13
Cigna
Setting
Professional
Modifier
Global
Typical Low
$44.67
Median
$61.66
Typical High
$120.23
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$42.66
Median
$51.29
Typical High
$134.90
Medcost
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$83.18
Typical High
$109.65
Medcost
Setting
Facility
Modifier
Global
Typical Low
$40.74
Median
$63.10
Typical High
$95.50
Sentara
Setting
Facility
Modifier
Global
Typical Low
$45.71
Median
$63.10
Typical High
$8,709.64
Sentara
Setting
Professional
Modifier
Global
Typical Low
$45.71
Median
$63.10
Typical High
$8,709.64
United
Setting
Facility
Modifier
Global
Typical Low
$3,801.89
Median
$6,309.57
Typical High
$13,489.63
United
Setting
Professional
Modifier
Global
Typical Low
$38.90
Median
$58.88
Typical High
$95.50

Where Virginia 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.

Virginia $64.57 · 40th 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.