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Genital Reconstruction Surgery

California 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?

$9,772

Typical negotiated rate. In California, July 2026.

Insurers have agreed to pay about $9,772 for this service. The price depends on where it is billed: about $4,898 from a physician practice, and about $10,965 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$4,898$3,631 to $9,772
FacilityA hospital or hospital-owned outpatient department$10,965$7,413 to $14,125

How much rates vary

Facilitymedian $10,965 · 10th to 90th $4,571 to $19,055Professionalmedian $4,898 · 10th to 90th $40 to $14,125
$50$200$1K$5K$20Kfacility $10,965professional $4,898

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
$4,897.79
Median
$10,000.00
Typical High
$22,908.68
Aetna
Setting
Professional
Modifier
Global
Typical Low
$3,801.89
Median
$9,772.37
Typical High
$11,481.54
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$6,760.83
Median
$11,481.54
Typical High
$18,620.87
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$2,187.76
Median
$3,311.31
Typical High
$7,585.78
Blue Shield
Setting
Facility
Modifier
Global
Typical Low
$72.44
Median
$3,630.78
Typical High
$7,943.28
Blue Shield
Setting
Professional
Modifier
Global
Typical Low
$39.81
Median
$39.81
Typical High
$39.81
Cigna
Setting
Facility
Modifier
Global
Typical Low
$4,265.80
Median
$4,265.80
Typical High
$4,265.80
Cigna
Setting
Professional
Modifier
Global
Typical Low
$3,548.13
Median
$5,248.07
Typical High
$11,220.18
Contra Costa Health
Setting
Professional
Modifier
Global
Typical Low
$3,162.28
Median
$3,162.28
Typical High
$3,311.31
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$398.11
Typical High
$1,698.24
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$54.95
Median
$12,589.25
Typical High
$23,988.33
Lucent Health
Setting
Professional
Modifier
Global
Typical Low
$29,512.09
Median
$33,884.42
Typical High
$33,884.42
Providence
Setting
Facility
Modifier
Global
Typical Low
$4,265.80
Median
$5,248.07
Typical High
$9,772.37
Providence
Setting
Professional
Modifier
Global
Typical Low
$2,691.53
Median
$4,786.30
Typical High
$10,000.00
United
Setting
Facility
Modifier
Global
Typical Low
$1,995.26
Median
$6,165.95
Typical High
$17,378.01
United
Setting
Professional
Modifier
Global
Typical Low
$3,090.30
Median
$4,570.88
Typical High
$10,964.78

Where California sits

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.

California· 4th of 51

$9,772

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.