go back

Genital Reconstruction Surgery

South 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?

$5,012

Typical negotiated rate. In South Carolina, July 2026.

Insurers have agreed to pay about $5,012 for this service. The price depends on where it is billed: about $5,012 from a physician practice, and about $7,943 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$5,012$3,715 to $5,012
FacilityA hospital or hospital-owned outpatient department$7,943$5,012 to $14,454

How much rates vary

Facilitymedian $7,943 · 10th to 90th $3,981 to $22,909Professionalmedian $5,012 · 10th to 90th $3,715 to $9,772
$50$200$1K$5K$20Kfacility $7,943professional $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
$5,011.87
Median
$9,120.11
Typical High
$22,908.68
Aetna
Setting
Professional
Modifier
Global
Typical Low
$3,715.35
Median
$5,011.87
Typical High
$9,772.37
BCBS
Setting
Facility
Modifier
Global
Typical Low
$2,137.96
Median
$7,585.78
Typical High
$13,182.57
Cigna
Setting
Professional
Modifier
Global
Typical Low
$489.78
Median
$5,754.40
Typical High
$10,471.29
Medcost
Setting
Facility
Modifier
Global
Typical Low
$4,073.80
Median
$5,888.44
Typical High
$10,964.78
Molina
Setting
Professional
Modifier
Global
Typical Low
$30.20
Median
$30.20
Typical High
$54.95
United
Setting
Facility
Modifier
Global
Typical Low
$3,019.95
Median
$7,079.46
Typical High
$12,302.69
United
Setting
Professional
Modifier
Global
Typical Low
$3,548.13
Median
$4,365.16
Typical High
$7,585.78

Where South 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.

South Carolina· 27th 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.