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Genital Reconstruction Surgery

Illinois 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?

$4,571

Typical negotiated rate. In Illinois, July 2026.

Insurers have agreed to pay about $4,571 for this service. The price depends on where it is billed: about $4,677 from a physician practice, and about $4,467 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 5 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$4,677$3,981 to $7,762
FacilityA hospital or hospital-owned outpatient department$4,467$1,862 to $5,623

How much rates vary

Facilitymedian $4,467 · 10th to 90th $1,148 to $9,333Professionalmedian $4,677 · 10th to 90th $3,467 to $9,772
$500$1K$2K$5K$10Kfacility $4,467professional $4,677

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
$1,148.15
Median
$4,466.84
Typical High
$9,772.37
Aetna
Setting
Professional
Modifier
Global
Typical Low
$3,467.37
Median
$4,570.88
Typical High
$9,772.37
BCBS
Setting
Facility
Modifier
Global
Typical Low
$3,235.94
Median
$7,244.36
Typical High
$8,709.64
Cigna
Setting
Professional
Modifier
Global
Typical Low
$512.86
Median
$5,370.32
Typical High
$7,585.78
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$199.53
Typical High
$346.74
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
United
Setting
Facility
Modifier
Global
Typical Low
$1,148.15
Median
$3,981.07
Typical High
$10,000.00
United
Setting
Professional
Modifier
Global
Typical Low
$3,801.89
Median
$5,248.07
Typical High
$8,317.64

Where Illinois 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.

Illinois· 34th of 51

$4,571

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.