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Genital Reconstruction Surgery

Wisconsin 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 Wisconsin, July 2026.

Insurers have agreed to pay about $5,888 for this service. The price depends on where it is billed: about $6,918 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 9 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$6,918$4,898 to $11,482
FacilityA hospital or hospital-owned outpatient department$5,012$3,981 to $6,918

How much rates vary

Facilitymedian $5,012 · 10th to 90th $3,311 to $8,128Professionalmedian $6,918 · 10th to 90th $3,715 to $16,596
$2K$5K$10K$20Kfacility $5,012professional $6,918

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
$4,168.69
Median
$4,168.69
Typical High
$17,782.79
Aetna
Setting
Professional
Modifier
Global
Typical Low
$3,548.13
Median
$4,168.69
Typical High
$6,456.54
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$3,311.31
Median
$4,897.79
Typical High
$7,585.78
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$3,715.35
Median
$7,079.46
Typical High
$17,378.01
Cigna
Setting
Facility
Modifier
Global
Typical Low
$7,413.10
Median
$8,709.64
Typical High
$13,803.84
Cigna
Setting
Professional
Modifier
Global
Typical Low
$4,677.35
Median
$10,715.19
Typical High
$12,302.69
DeanCare
Setting
Facility
Modifier
Global
Typical Low
$4,677.35
Median
$7,943.28
Typical High
$14,454.40
Medica
Setting
Facility
Modifier
Global
Typical Low
$2,570.40
Median
$4,786.30
Typical High
$12,589.25
Medica
Setting
Professional
Modifier
Global
Typical Low
$3,890.45
Median
$7,079.46
Typical High
$19,054.61
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$50.12
Typical High
$70.79
Prevea360
Setting
Facility
Modifier
Global
Typical Low
$4,168.69
Median
$4,677.35
Typical High
$8,128.31
Quartz
Setting
Professional
Modifier
Global
Typical Low
$5,128.61
Median
$9,120.11
Typical High
$13,489.63
Quartz
Setting
Facility
Modifier
Global
Typical Low
$9,772.37
Median
$9,772.37
Typical High
$23,988.33
Quartz
Setting
Professional
Modifier
Global
Typical Low
$5,248.07
Median
$12,022.64
Typical High
$29,512.09
United
Setting
Facility
Modifier
Global
Typical Low
$1,995.26
Median
$5,370.32
Typical High
$19,498.45
United
Setting
Professional
Modifier
Global
Typical Low
$3,801.89
Median
$5,888.44
Typical High
$16,218.10

Where Wisconsin 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.

Wisconsin· 18th 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.