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Genital Reconstruction Surgery

West 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?

$4,074

Typical negotiated rate. In West Virginia, July 2026.

Insurers have agreed to pay about $4,074 for this service. The price depends on where it is billed: about $4,074 from a physician practice, and about $3,890 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 3 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$3,802 to $4,677
FacilityA hospital or hospital-owned outpatient department$3,890$3,890 to $3,890

How much rates vary

Facilitymedian $3,890 · 10th to 90th $1,413 to $6,607Professionalmedian $4,074 · 10th to 90th $3,802 to $5,248
$50$200$1K$5Kfacility $3,890professional $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
$1,412.54
Median
$3,890.45
Typical High
$3,890.45
Aetna
Setting
Professional
Modifier
Global
Typical Low
$3,801.89
Median
$4,073.80
Typical High
$4,677.35
Cigna
Setting
Facility
Modifier
Global
Typical Low
$34.67
Median
$6,606.93
Typical High
$6,606.93
Cigna
Setting
Professional
Modifier
Global
Typical Low
$3,548.13
Median
$5,248.07
Typical High
$18,620.87
United
Setting
Facility
Modifier
Global
Typical Low
$758.58
Median
$8,709.64
Typical High
$14,125.38
United
Setting
Professional
Modifier
Global
Typical Low
$3,019.95
Median
$4,265.80
Typical High
$6,606.93

Where West 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.

West Virginia· 48th of 51

$4,074

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.