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Genital Reconstruction Surgery

Utah 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?

$5,248

Typical negotiated rate. In Utah, July 2026.

Insurers have agreed to pay about $5,248 for this service. The price depends on where it is billed: about $5,248 from a physician practice, and about $4,571 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$5,248$4,571 to $7,586
FacilityA hospital or hospital-owned outpatient department$4,571$4,169 to $9,772

How much rates vary

Facilitymedian $4,571 · 10th to 90th $3,162 to $9,772Professionalmedian $5,248 · 10th to 90th $3,890 to $9,772
$50$200$1K$5Kfacility $4,571professional $5,248

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
$3,162.28
Median
$4,570.88
Typical High
$9,772.37
Aetna
Setting
Professional
Modifier
Global
Typical Low
$3,890.45
Median
$5,248.07
Typical High
$9,772.37
Cigna
Setting
Professional
Modifier
Global
Typical Low
$2,884.03
Median
$5,495.41
Typical High
$8,317.64
Molina
Setting
Professional
Modifier
Global
Typical Low
$30.20
Median
$44.67
Typical High
$60.26
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$7,079.46
Median
$9,772.37
Typical High
$14,791.08
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$4,897.79
Median
$5,754.40
Typical High
$6,606.93
Select Health
Setting
Facility
Modifier
Global
Typical Low
$5,011.87
Median
$5,011.87
Typical High
$5,011.87
Select Health
Setting
Professional
Modifier
Global
Typical Low
$5,011.87
Median
$5,011.87
Typical High
$5,011.87
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$5,011.87
Median
$5,370.32
Typical High
$6,165.95
United
Setting
Facility
Modifier
Global
Typical Low
$1,288.25
Median
$4,466.84
Typical High
$13,803.84
United
Setting
Professional
Modifier
Global
Typical Low
$3,548.13
Median
$4,897.79
Typical High
$7,762.47

Where Utah 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.

Utah· 22nd of 51

$5,248

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.