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Genital Reconstruction Surgery

Montana 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?

$6,761

Typical negotiated rate. In Montana, July 2026.

Insurers have agreed to pay about $6,761 for this service. The price depends on where it is billed: about $6,310 from a physician practice, and about $6,761 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$6,310$4,074 to $6,918
FacilityA hospital or hospital-owned outpatient department$6,761$6,310 to $6,918

How much rates vary

Facilitymedian $6,761 · 10th to 90th $2,570 to $14,125Professionalmedian $6,310 · 10th to 90th $2,570 to $7,943
$100$200$500$1K$2K$5K$10Kfacility $6,761professional $6,310

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
$4,073.80
Median
$4,073.80
Typical High
$4,073.80
Cigna
Setting
Facility
Modifier
Global
Typical Low
$6,309.57
Median
$6,309.57
Typical High
$6,309.57
Cigna
Setting
Professional
Modifier
Global
Typical Low
$6,309.57
Median
$6,309.57
Typical High
$6,309.57
MountainHealth Co-op
Setting
Facility
Modifier
Global
Typical Low
$2,570.40
Median
$6,918.31
Typical High
$14,125.38
MountainHealth Co-op
Setting
Professional
Modifier
Global
Typical Low
$2,570.40
Median
$6,918.31
Typical High
$14,125.38
Providence
Setting
Facility
Modifier
Global
Typical Low
$3,548.13
Median
$5,888.44
Typical High
$6,309.57
Providence
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$85.11
Typical High
$7,943.28
United
Setting
Professional
Modifier
Global
Typical Low
$5,011.87
Median
$6,309.57
Typical High
$9,332.54

Where Montana 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.

Montana· 12th of 51

$6,761

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.