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Genital Reconstruction Surgery

Massachusetts 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?

$7,413

Typical negotiated rate. In Massachusetts, July 2026.

Insurers have agreed to pay about $7,413 for this service. The price depends on where it is billed: about $7,762 from a physician practice, and about $3,715 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 8 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$7,762$4,571 to $9,772
FacilityA hospital or hospital-owned outpatient department$3,715$2,884 to $7,586

How much rates vary

Facilitymedian $3,715 · 10th to 90th $2,692 to $8,913Professionalmedian $7,762 · 10th to 90th $4,074 to $10,471
$1K$2K$5K$10K$20Kfacility $3,715professional $7,762

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
$2,691.53
Median
$3,715.35
Typical High
$8,912.51
Aetna
Setting
Professional
Modifier
Global
Typical Low
$4,073.80
Median
$8,912.51
Typical High
$9,772.37
AllWays Health Partners
Setting
Facility
Modifier
Global
Typical Low
$1,862.09
Median
$4,897.79
Typical High
$23,988.33
AllWays Health Partners
Setting
Professional
Modifier
Global
Typical Low
$4,786.30
Median
$8,709.64
Typical High
$22,387.21
BCBS
Setting
Professional
Modifier
Global
Typical Low
$4,570.88
Median
$7,943.28
Typical High
$10,471.29
Cigna
Setting
Professional
Modifier
Global
Typical Low
$616.60
Median
$5,888.44
Typical High
$10,964.78
Fallon Health
Setting
Facility
Modifier
Global
Typical Low
$302.00
Median
$3,630.78
Typical High
$8,511.38
Fallon Health
Setting
Professional
Modifier
Global
Typical Low
$5,248.07
Median
$5,248.07
Typical High
$6,165.95
Harvard Pilgrim
Setting
Facility
Modifier
Global
Typical Low
$1,023.29
Median
$3,388.44
Typical High
$5,888.44
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$3,890.45
Median
$6,309.57
Typical High
$10,232.93
Mass General Brigham
Setting
Facility
Modifier
Global
Typical Low
$1,862.09
Median
$4,897.79
Typical High
$23,988.33
Mass General Brigham
Setting
Professional
Modifier
Global
Typical Low
$4,786.30
Median
$8,709.64
Typical High
$22,387.21
United
Setting
Facility
Modifier
Global
Typical Low
$1,862.09
Median
$3,548.13
Typical High
$16,595.87
United
Setting
Professional
Modifier
Global
Typical Low
$4,265.80
Median
$6,606.93
Typical High
$12,022.64

Where Massachusetts 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.

Massachusetts· 9th of 51

$7,413

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.