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Genital Reconstruction Surgery

Nationwide rates for HCPCS 55970

Reconstructs the genitals as part of gender-affirming care, reshaping and rebuilding the existing tissue to match the person's gender identity. It is major surgery, usually the last step after hormone treatment and a period of living in the affirmed gender, and it is often done in more than one stage. Recovery involves a hospital stay and a long period of careful aftercare.

Rates data updated July 2026.

How much does Genital Reconstruction Surgery cost?

$5,129

Typical negotiated rate. Nationwide, July 2026.

Insurers have agreed to pay about $5,129 for this service. The price depends on where it is billed: about $4,786 from a physician practice, and about $6,761 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 51 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$4,786$3,802 to $7,244
FacilityA hospital or hospital-owned outpatient department$6,761$3,890 to $10,715

How much rates vary

Facilitymedian $6,761 · 10th to 90th $2,089 to $15,136Professionalmedian $4,786 · 10th to 90th $3,311 to $9,772
$50$200$1K$5K$20Kfacility $6,761professional $4,786

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
$1,621.81
Median
$5,011.87
Typical High
$12,302.69
Aetna
Setting
Professional
Modifier
Global
Typical Low
$3,548.13
Median
$4,677.35
Typical High
$9,772.37
BCBS
Setting
Facility
Modifier
Global
Typical Low
$2,951.21
Median
$8,317.64
Typical High
$16,982.44
BCBS
Setting
Professional
Modifier
Global
Typical Low
$2,238.72
Median
$3,311.31
Typical High
$7,079.46
Cigna
Setting
Facility
Modifier
Global
Typical Low
$6,025.60
Median
$8,709.64
Typical High
$27,542.29
Cigna
Setting
Professional
Modifier
Global
Typical Low
$3,311.31
Median
$6,025.60
Typical High
$11,748.98
United
Setting
Facility
Modifier
Global
Typical Low
$1,096.48
Median
$3,981.07
Typical High
$11,748.98
United
Setting
Professional
Modifier
Global
Typical Low
$3,311.31
Median
$4,786.30
Typical High
$9,120.11

What it costs in each state

The same service costs 4.4 times more in Alaska than in North Dakota. 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.

Touch or drag across the chart to see any state's rate.

AK $16,218ND $3,715

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.