Price Checker / CPT 56442
How much does Hymenotomy cost?
CPT 56442 · Based on 2026 Medicare rates and hospital-published pricing
The average hospital charge is around 60x the fair price — among the most extreme markups. Dispute this.
Fair price
$65–$130
What this should cost
With insurance
~$2,800
Typical out-of-pocket
Overcharged if over
$160
Push back above this
The average hospital charge of $6,014 is $5,914 over the fair price (about 60x the fair rate).
What hospitals charge for Hymenotomy
From hospital-published transparency (MRF) files. These are the hospitals in our database that list this procedure.
| Hospital | Gross Charge | Cash Rate | vs Medicare |
|---|---|---|---|
| "Children's Hospital of Michigan" DETROIT, MI | — | — | 40814% |
| MultiCare Good Samaritan Hospital PUYALLUP, WA | — | — | 33797% |
| UCSF Health Saint Francis Hospital SAN FRANCISCO, CA | — | — | 32017% |
| Dominican Hospital SANTA CRUZ, CA | — | — | 31144% |
| HCA HOUSTON HEALTHCARE SOUTHEAST Pasadena, TX | — | — | 26180% |
| Mid Coast Hospital , ME | — | — | 25278% |
| Arroyo Grande Community Hospital , CA | — | — | 23965% |
| "St. John's Hospital Camarillo" SPRINGFIELD, CA | — | — | 23881% |
| MultiCare Yakima Memorial Hospital , WA | — | — | 23768% |
| Oregon Health and Science University , OR | $10,013 | $6,508 | 22782% |
| St. Anne Hospital , WA | $9,876 | $3,016 | 22469% |
| JONES MEMORIAL HOSPITAL WELLSVILLE, NY | — | — | 22176% |
| FREDERICK FERRIS THOMPSON HOSPITAL , NY | — | — | 21389% |
| JFK Memorial Hospital , CA | — | — | 20887% |
| Carle Health Proctor Hospital PEORIA, IL | — | — | 20577% |
Were you billed for this procedure?
Send us your bill and we'll compare every line item against Medicare rates and your hospital's published prices. Free review, no obligation.
About Hymenotomy
CPT code 56442 refers to hymenotomy (billing description: "Hymenotomy"). Under the 2026 Medicare Physician Fee Schedule, it is reimbursed at $44 in a facility (hospital or surgery center) and $44 in a doctor's office.
The Medicare rate is the closest thing to an objective "what this work is actually worth." A fair cash price for the uninsured is generally 1.5–3x that rate. Hospital sticker (gross) charges are often far higher — but almost nobody actually pays them.
What to do if you were overcharged
- 1Send us your bill — we'll identify this code and compare it against the rates shown above.
- 2Get a dispute letter — citing the Medicare rate and your hospital's own published pricing data.
- 3We negotiate for you — 25% of savings, no savings = no fee.