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Genital Reconstruction Surgery

Maine 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?

$5,248

Typical physician fee. In Maine, July 2026.

Insurers have agreed to pay about $5,248 for this service. Most negotiated rates run $4,169 to $7,244.

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 6 insurance carriers under federal price transparency rules.

How much rates vary

Professionalmedian $5,248 · 10th to 90th $3,311 to $9,772
$5K$10Kprofessional $5,248

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
Professional
Modifier
Global
Typical Low
$3,715.35
Median
$3,715.35
Typical High
$9,772.37
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$2,511.89
Median
$3,311.31
Typical High
$3,801.89
Cigna
Setting
Professional
Modifier
Global
Typical Low
$4,570.88
Median
$5,888.44
Typical High
$8,709.64
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$4,677.35
Median
$5,623.41
Typical High
$9,549.93
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$3,715.35
Median
$3,715.35
Typical High
$11,481.54
United
Setting
Professional
Modifier
Global
Typical Low
$4,677.35
Median
$5,495.41
Typical High
$10,715.19

Where Maine 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.

Maine· 23rd of 51

$5,248

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.