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Genital Reconstruction Surgery

Kentucky 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?

$3,890

Typical negotiated rate. In Kentucky, July 2026.

Insurers have agreed to pay about $3,890 for this service. The price depends on where it is billed: about $3,715 from a physician practice, and about $6,607 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$3,715$3,311 to $4,266
FacilityA hospital or hospital-owned outpatient department$6,607$3,715 to $10,715

How much rates vary

Facilitymedian $6,607 · 10th to 90th $851 to $11,220Professionalmedian $3,715 · 10th to 90th $2,818 to $6,166
$50$200$1K$5K$20Kfacility $6,607professional $3,715

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
$851.14
Median
$3,715.35
Typical High
$8,511.38
Aetna
Setting
Professional
Modifier
Global
Typical Low
$3,715.35
Median
$3,981.07
Typical High
$7,762.47
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$5,011.87
Median
$10,715.19
Typical High
$11,220.18
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$2,754.23
Median
$3,311.31
Typical High
$4,570.88
Cigna
Setting
Facility
Modifier
Global
Typical Low
$34.67
Median
$6,606.93
Typical High
$6,606.93
Cigna
Setting
Professional
Modifier
Global
Typical Low
$3,981.07
Median
$18,620.87
Typical High
$18,620.87
Molina
Setting
Professional
Modifier
Global
Typical Low
$44.67
Median
$44.67
Typical High
$44.67
United
Setting
Facility
Modifier
Global
Typical Low
$707.95
Median
$4,466.84
Typical High
$28,183.83
United
Setting
Professional
Modifier
Global
Typical Low
$3,311.31
Median
$5,128.61
Typical High
$6,918.31

Where Kentucky 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.

Kentucky· 50th of 51

$3,890

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.