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Genital Reconstruction Surgery

New Mexico 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?

$5,012

Typical negotiated rate. In New Mexico, July 2026.

Insurers have agreed to pay about $5,012 for this service. The price depends on where it is billed: about $4,266 from a physician practice, and about $20,893 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$4,266$3,548 to $6,457
FacilityA hospital or hospital-owned outpatient department$20,893$7,586 to $33,884

How much rates vary

Facilitymedian $20,893 · 10th to 90th $4,169 to $41,687Professionalmedian $4,266 · 10th to 90th $3,548 to $6,457
$1K$2K$5K$10K$20K$50Kfacility $20,893professional $4,266

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
$1,000.00
Median
$2,089.30
Typical High
$7,762.47
Aetna
Setting
Professional
Modifier
Global
Typical Low
$3,548.13
Median
$3,715.35
Typical High
$6,456.54
BCBS
Setting
Facility
Modifier
Global
Typical Low
$7,079.46
Median
$25,703.96
Typical High
$42,657.95
BCBS
Setting
Professional
Modifier
Global
Typical Low
$3,235.94
Median
$4,265.80
Typical High
$6,309.57
Cigna
Setting
Professional
Modifier
Global
Typical Low
$549.54
Median
$5,754.40
Typical High
$8,128.31
Molina
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$60.26
Typical High
$85.11
Providence
Setting
Facility
Modifier
Global
Typical Low
$4,168.69
Median
$5,495.41
Typical High
$9,772.37
Providence
Setting
Professional
Modifier
Global
Typical Low
$4,265.80
Median
$6,456.54
Typical High
$8,128.31
United
Setting
Facility
Modifier
Global
Typical Low
$3,235.94
Median
$8,317.64
Typical High
$21,877.62
United
Setting
Professional
Modifier
Global
Typical Low
$4,365.16
Median
$5,754.40
Typical High
$8,511.38

Where New Mexico 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 Mexico· 26th of 51

$5,012

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.