The Philadelphia Center for Transgender Surgery maintains a price list for affirming procedures that can help individuals estimate the potential out-of-pocket costs for care. Feminization surgery can cost anywhere from $3,000 to $40,000 depending on the desired procedures. Top surgery can cost $10,000. Hormone replacement therapy can cost $1,500.[8] The National Center for Transgender Equality recommends patients apply for preauthorization for transition-related care. If the preauthorization is denied, patients can appeal the denial with assistance from an attorney.