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Genital Reconstruction Surgery

South Dakota 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 South Dakota, July 2026.

Insurers have agreed to pay about $5,888 for this service. The price depends on where it is billed: about $6,310 from a physician practice, and about $4,365 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$6,310$3,548 to $8,128
FacilityA hospital or hospital-owned outpatient department$4,365$4,365 to $5,495

How much rates vary

Facilitymedian $4,365 · 10th to 90th $1,995 to $10,965Professionalmedian $6,310 · 10th to 90th $3,236 to $8,128
$2K$5K$10K$20Kfacility $4,365professional $6,310

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. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$3,715.35
Median
$4,365.16
Typical High
$4,365.16
Aetna
Setting
Professional
Modifier
Global
Typical Low
$3,235.94
Median
$3,235.94
Typical High
$3,548.13
Cigna
Setting
Professional
Modifier
Global
Typical Low
$6,606.93
Median
$6,606.93
Typical High
$8,128.31
Medica
Setting
Facility
Modifier
Global
Typical Low
$1,995.26
Median
$5,248.07
Typical High
$10,964.78
Medica
Setting
Professional
Modifier
Global
Typical Low
$3,801.89
Median
$6,606.93
Typical High
$28,840.32
Midlands
Setting
Professional
Modifier
Global
Typical Low
$4,786.30
Median
$7,413.10
Typical High
$8,912.51
Midlands
Setting
Professional
Modifier
Global
Typical Low
$4,786.30
Median
$4,786.30
Typical High
$4,786.30
United
Setting
Facility
Modifier
Global
Typical Low
$1,995.26
Median
$1,995.26
Typical High
$1,995.26
United
Setting
Professional
Modifier
Global
Typical Low
$3,801.89
Median
$5,888.44
Typical High
$10,232.93
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$3,801.89
Median
$3,801.89
Typical High
$3,801.89

Where South Dakota 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 Dakota· 16th 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.