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Genital Reconstruction Surgery

Virginia 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 Virginia, 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 $5,012 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$4,074$3,715 to $4,786
FacilityA hospital or hospital-owned outpatient department$5,012$3,802 to $7,079

How much rates vary

Facilitymedian $5,012 · 10th to 90th $3,236 to $10,000Professionalmedian $4,074 · 10th to 90th $3,090 to $6,607
$2K$5K$10Kfacility $5,012professional $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
$3,630.78
Median
$5,370.32
Typical High
$14,125.38
Aetna
Setting
Professional
Modifier
Global
Typical Low
$3,801.89
Median
$4,073.80
Typical High
$6,165.95
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$3,090.30
Median
$3,981.07
Typical High
$4,466.84
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$2,691.53
Median
$3,311.31
Typical High
$5,128.61
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$5,370.32
Median
$6,918.31
Typical High
$8,317.64
Cigna
Setting
Professional
Modifier
Global
Typical Low
$3,235.94
Median
$5,370.32
Typical High
$10,232.93
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$3,715.35
Median
$4,466.84
Typical High
$5,495.41
Medcost
Setting
Facility
Modifier
Global
Typical Low
$3,801.89
Median
$4,897.79
Typical High
$8,511.38
Sentara
Setting
Facility
Modifier
Global
Typical Low
$3,801.89
Median
$5,754.40
Typical High
$10,964.78
Sentara
Setting
Professional
Modifier
Global
Typical Low
$3,801.89
Median
$5,754.40
Typical High
$10,964.78
United
Setting
Facility
Modifier
Global
Typical Low
$1,737.80
Median
$4,073.80
Typical High
$7,244.36
United
Setting
Professional
Modifier
Global
Typical Low
$3,235.94
Median
$4,897.79
Typical High
$7,943.28

Where Virginia 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.

Virginia· 41st 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.