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Genital Reconstruction Surgery

New Jersey 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?

$5,888

Typical negotiated rate. In New Jersey, July 2026.

Insurers have agreed to pay about $5,888 for this service. The price depends on where it is billed: about $5,012 from a physician practice, and about $9,120 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 4 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$5,012$3,715 to $9,120
FacilityA hospital or hospital-owned outpatient department$9,120$6,026 to $10,965

How much rates vary

Facilitymedian $9,120 · 10th to 90th $4,467 to $28,184Professionalmedian $5,012 · 10th to 90th $3,467 to $9,772
$2K$5K$10K$20Kfacility $9,120professional $5,012

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
$4,466.84
Median
$9,332.54
Typical High
$28,183.83
Aetna
Setting
Professional
Modifier
Global
Typical Low
$3,548.13
Median
$5,623.41
Typical High
$9,772.37
Cigna
Setting
Professional
Modifier
Global
Typical Low
$812.83
Median
$4,365.16
Typical High
$12,302.69
Horizon BCBS
Setting
Facility
Modifier
Global
Typical Low
$10,232.93
Median
$15,848.93
Typical High
$25,118.86
Horizon BCBS
Setting
Professional
Modifier
Global
Typical Low
$3,090.30
Median
$4,265.80
Typical High
$9,772.37
United
Setting
Facility
Modifier
Global
Typical Low
$1,412.54
Median
$5,248.07
Typical High
$10,471.29
United
Setting
Professional
Modifier
Global
Typical Low
$2,630.27
Median
$3,630.78
Typical High
$8,128.31

Where New Jersey 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.

New Jersey· 17th of 51

$5,888

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.