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Genital Reconstruction Surgery

New York 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?

$4,266

Typical negotiated rate. In New York, July 2026.

Insurers have agreed to pay about $4,266 for this service. The price depends on where it is billed: about $3,631 from a physician practice, and about $4,898 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 8 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$3,631$2,455 to $6,310
FacilityA hospital or hospital-owned outpatient department$4,898$3,236 to $7,413

How much rates vary

Facilitymedian $4,898 · 10th to 90th $2,570 to $10,233Professionalmedian $3,631 · 10th to 90th $2,042 to $9,772
$1K$2K$5K$10K$20Kfacility $4,898professional $3,631

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
$1,905.46
Median
$6,309.57
Typical High
$12,022.64
Aetna
Setting
Professional
Modifier
Global
Typical Low
$3,548.13
Median
$5,011.87
Typical High
$9,772.37
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$2,630.27
Median
$4,786.30
Typical High
$9,120.11
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$1,949.84
Median
$2,454.71
Typical High
$5,248.07
CDPHP
Setting
Facility
Modifier
Global
Typical Low
$5,370.32
Median
$5,370.32
Typical High
$5,370.32
CDPHP
Setting
Professional
Modifier
Global
Typical Low
$5,370.32
Median
$5,370.32
Typical High
$5,370.32
Cigna
Setting
Facility
Modifier
Global
Typical Low
$34.67
Median
$6,606.93
Typical High
$7,762.47
Cigna
Setting
Professional
Modifier
Global
Typical Low
$851.14
Median
$8,128.31
Typical High
$18,620.87
Excellus BCBS
Setting
Professional
Modifier
Global
Typical Low
$2,884.03
Median
$5,623.41
Typical High
$9,772.37
MVP Health Care
Setting
Facility
Modifier
Global
Typical Low
$50,118.72
Median
$53,703.18
Typical High
$75,857.76
MVP Health Care
Setting
Professional
Modifier
Global
Typical Low
$398.11
Median
$398.11
Typical High
$398.11
United
Setting
Facility
Modifier
Global
Typical Low
$1,513.56
Median
$4,265.80
Typical High
$11,481.54
United
Setting
Professional
Modifier
Global
Typical Low
$2,951.21
Median
$4,365.16
Typical High
$12,022.64
Univera
Setting
Facility
Modifier
Global
Typical Low
$3,162.28
Median
$5,248.07
Typical High
$5,248.07
Univera
Setting
Professional
Modifier
Global
Typical Low
$2,884.03
Median
$5,248.07
Typical High
$10,000.00

Where New York 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 York· 42nd of 51

$4,266

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.