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Genital Reconstruction Surgery

Texas 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?

$4,365

Typical negotiated rate. In Texas, July 2026.

Insurers have agreed to pay about $4,365 for this service. The price depends on where it is billed: about $4,467 from a physician practice, and about $4,266 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$4,467$3,802 to $6,166
FacilityA hospital or hospital-owned outpatient department$4,266$2,754 to $7,079

How much rates vary

Facilitymedian $4,266 · 10th to 90th $1,000 to $12,589Professionalmedian $4,467 · 10th to 90th $3,467 to $14,125
$100$500$2K$10Kfacility $4,266professional $4,467

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
$3,715.35
Typical High
$12,302.69
Aetna
Setting
Professional
Modifier
Global
Typical Low
$3,467.37
Median
$4,073.80
Typical High
$6,760.83
BCBS
Setting
Facility
Modifier
Global
Typical Low
$3,162.28
Median
$7,079.46
Typical High
$12,302.69
BCBS
Setting
Professional
Modifier
Global
Typical Low
$14,125.38
Median
$14,125.38
Typical High
$14,125.38
Cigna
Setting
Professional
Modifier
Global
Typical Low
$3,467.37
Median
$4,677.35
Typical High
$7,413.10
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$54.95
Median
$12,589.25
Typical High
$23,988.33
Lucent Health
Setting
Professional
Modifier
Global
Typical Low
$29,512.09
Median
$33,884.42
Typical High
$33,884.42
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$3,801.89
Median
$5,128.61
Typical High
$9,772.37
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$3,715.35
Median
$6,165.95
Typical High
$6,165.95
Providence
Setting
Facility
Modifier
Global
Typical Low
$3,715.35
Median
$5,128.61
Typical High
$9,772.37
Providence
Setting
Professional
Modifier
Global
Typical Low
$3,388.44
Median
$4,786.30
Typical High
$7,585.78
United
Setting
Facility
Modifier
Global
Typical Low
$501.19
Median
$2,951.21
Typical High
$10,232.93
United
Setting
Professional
Modifier
Global
Typical Low
$3,090.30
Median
$4,265.80
Typical High
$6,606.93
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$3,311.31
Median
$3,801.89
Typical High
$5,128.61

Where Texas 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.

Texas· 38th of 51

$4,365

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.