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Genital Reconstruction Surgery

Ohio 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 Ohio, July 2026.

Insurers have agreed to pay about $4,266 for this service. The price depends on where it is billed: about $4,074 from a physician practice, and about $5,129 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 7 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$4,074$3,548 to $5,248
FacilityA hospital or hospital-owned outpatient department$5,129$3,311 to $9,550

How much rates vary

Facilitymedian $5,129 · 10th to 90th $1,778 to $12,589Professionalmedian $4,074 · 10th to 90th $3,236 to $8,913
$100$200$500$1K$2K$5K$10Kfacility $5,129professional $4,074

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
$4,073.80
Median
$8,912.51
Typical High
$12,589.25
Aetna
Setting
Professional
Modifier
Global
Typical Low
$3,548.13
Median
$4,073.80
Typical High
$10,715.19
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,000.00
Median
$3,019.95
Typical High
$7,943.28
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$3,235.94
Median
$3,890.45
Typical High
$6,918.31
Cigna
Setting
Facility
Modifier
Global
Typical Low
$6,606.93
Median
$6,606.93
Typical High
$21,379.62
Cigna
Setting
Professional
Modifier
Global
Typical Low
$416.87
Median
$4,570.88
Typical High
$7,585.78
Medical Mutual of Ohio
Setting
Facility
Modifier
Global
Typical Low
$21,379.62
Median
$21,379.62
Typical High
$21,379.62
Medical Mutual of Ohio
Setting
Professional
Modifier
Global
Typical Low
$416.87
Median
$4,570.88
Typical High
$7,585.78
Molina
Setting
Professional
Modifier
Global
Typical Low
$39.81
Median
$50.12
Typical High
$60.26
SummaCare
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$70.79
Typical High
$75.86
United
Setting
Facility
Modifier
Global
Typical Low
$1,862.09
Median
$3,801.89
Typical High
$9,120.11
United
Setting
Professional
Modifier
Global
Typical Low
$3,311.31
Median
$4,466.84
Typical High
$7,413.10

Where Ohio 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.

Ohio· 40th 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.