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Genital Reconstruction Surgery

North Carolina 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?

$4,677

Typical negotiated rate. In North Carolina, July 2026.

Insurers have agreed to pay about $4,677 for this service. The price depends on where it is billed: about $4,677 from a physician practice, and about $4,169 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 6 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$3,715 to $7,079
FacilityA hospital or hospital-owned outpatient department$4,169$3,715 to $7,079

How much rates vary

Facilitymedian $4,169 · 10th to 90th $1,660 to $8,710Professionalmedian $4,677 · 10th to 90th $3,715 to $9,772
$1K$2K$5K$10K$20Kfacility $4,169professional $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
$1,659.59
Median
$3,715.35
Typical High
$8,709.64
Aetna
Setting
Professional
Modifier
Global
Typical Low
$3,715.35
Median
$3,801.89
Typical High
$5,128.61
BCBS
Setting
Professional
Modifier
Global
Typical Low
$4,786.30
Median
$7,079.46
Typical High
$10,715.19
Cigna
Setting
Professional
Modifier
Global
Typical Low
$4,073.80
Median
$5,754.40
Typical High
$9,120.11
Medcost
Setting
Facility
Modifier
Global
Typical Low
$3,715.35
Median
$4,168.69
Typical High
$7,943.28
United
Setting
Facility
Modifier
Global
Typical Low
$1,778.28
Median
$4,365.16
Typical High
$7,762.47
United
Setting
Professional
Modifier
Global
Typical Low
$3,548.13
Median
$4,677.35
Typical High
$8,511.38
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$12,589.25
Median
$23,988.33
Typical High
$23,988.33
Wellcare
Setting
Professional
Modifier
Global
Typical Low
$29,512.09
Median
$29,512.09
Typical High
$33,884.42

Where North Carolina 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.

North Carolina· 32nd of 51

$4,677

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.