Self-Pay/No Insurance Costs (Price Transparency)

View our prices:

Urology Services
Service Price
CPT 55250 = Vasectomy (consult & post vasectomy semen analysis included) $1,248.00
Note: Price above is with self-pay/no insurance/cash only; no discount is available for this service.

Imaging
Service Price
X-ray CPT = 71045 Chest $17.96
X-ray CPT = 71046 Chest 2 views $32.74
X-ray CPT = 74018 Abdominal (KUB) $30.10
X-ray CPT = 72170 Pelvic $38.55
X-ray CPT = 72190 Pelvic 3 views $45.42
Ultrasound CPT = 76700 Abdomen complete $211.25
Ultrasound CPT = 76705 Abdomen limited $157.91
Ultrasound CPT = 76856 Pelvic complete $190.13
Ultrasound CPT = 76857 Pelvic limited (bladder) $83.97
Ultrasound CPT = 76770 Renal complete $195.41
Ultrasound CPT = Renal complete $195.41
Ultrasound CPT = 76775 Renal limited $116.19
Ultrasound CPT = 76870 Scrotal/testicular $118.83
DEXA CPT = 77080 DEXA $71.83
CT CPT = 71250 Chest w/o contrast $176.92
CT CPT = 71260 Chest with contrast $227.09
CT CPT = 71270 Chest with and without contrast $281.49
CT CPT = 74150 Abdomen w/o contrast $152.10
CT CPT = 74160 Abdomen with contrast $283.08
CT CPT = 74170 Abdomen with and without contrast (CT RMP) $325.85
CT CPT = 72192 Pelvis w/o contrast $154.74
CT CPT = 72193 Pelvis with contrast $283.60
CT CPT = 72194 Pelvis with and without contrast $336.94
CT CPT = 74176 Abdomen & Pelvis w/o contrast (CT Urogram) $191.71
CT CPT = 74177 Abdomen & Pelvis with contrast $372.86
CT CPT = 74178 Abdomen & Pelvis with and without contrast (CT IVP) $420.92
Note: These prices do NOT include the radiologist fee to read/report which typically range from $30 to over $300. Prices above are with self-pay/no insurance/cash only 35% discount applied if paid in full before or on day of service.

Laboratory
Service Price
CPT = 36415 Venipuncture $6.34
CPT = 85025 CBC w/ auto $17.96
CPT = 85032 Manual cell count, each $10.03
CPT = 80048 Chem 8 basic metabolic $19.54
CPT = 80053 Chem 12 $24.29
CPT = 82565 Creatinine/blood $11.62
CPT = 85610 Prothrombin time $8.98
CPT = 84403 Testosterone total $59.15
CPT = 83002 Lh serum $42.25
CPT = 83001 Fsh $42.25
CPT = 82310 Assay of calcium $13.20
CPT = 84146 Prolactin $44.36
CPT = 84153 PSA total $41.72
CPT = G0103 PSA – MC screening $41.72
CPT = 81025 Urine pregnancy $15.84
CPT = 81002 UA manual dip $6.34
CPT = 81003 UA auto dip $5.28
CPT = 81001 UA auto dip w/ micro $7.39
CPT = 87086 Urine culture/colony $18.48
CPT = 87186 Mics $19.54
CPT = 87077 Pathogen identification $18.48
CPT = 87070 Culture bacteria/other $19.54
CPT = 89331 PEU $44.89
Note: Lab is CLIA certified; prices above are with self-pay/no insurance/cash only 35% discount applied if paid in full before or on day of service.

Infertility & Cryopreservation
Service Price
CPT 58322 = Intrauterine insemination (female) $279.00
CPT 89261 = Sperm wash $185.00
CPT 89260 = Frozen donor sperm preparation $165.00
CPT 99199 = Intrauterine insemination-ready frozen donor sperm prep $75.00
CPT 89260 = Semen wash $150.00
CPT 89259 = Cryopreservation of sperm $150.00
CPT 89343 = Storage of cryopreserved sperm for 1 month $75.00
CPT 89343 = Storage of cryopreserved sperm for 6 months $250.00
CPT 89343 = Storage of cryopreserved sperm for 1 year $375.00
CPT 89343 = Storage of cryopreserved sperm for 2 years $650.00
CPT 89343 = Storage of cryopreserved sperm for 3 years $825.00
CPT 89343 = Storage of cryopreserved sperm for 5 years $1,200.00
Note: Infertility and cryo services are typically self-pay/cash-pay since most insurances do not provide coverage. We ask that you please check with your insurance company in advance and if it is a covered service, please notify our staff. No discount is available for these services.

Mona Lisa Touch
Service Price
Three (3) treatment bundle $2,100.00
Annual maintenance treatment (one treatment following bundle only) $750.00
Note: We can ONLY perform this treatment if paying in full since we cannot bill insurance. No discount is available for these services.

Medical Items
Service Price
*Battery-powered vacuum erection device (VED) $175.00
*Manual-powered vacuum erection device (VED) $130.00
*Constriction ring size 3 $11.00
*Constriction ring size 4 $11.00
*Constriction ring size 5 $11.00
*FIRMA band $25.00
*Water-based lubricant $5.00
*Pessary (rubber or non-rubber) $75.00
*Promescent trial size 0.04 oz $22.00
*Promescent 0.25 oz $88.00
*Sensation seal size 3 $14.00
*Sensation seal size 4 $14.00
*RestoreX traction device $495.00
**Code = A4338 Foley catheter $22.00
**Code = A4352 Straight catheter $17.00
**Code = A4358 Leg bag (all brands) $8.00
**Code = A4357 Bedside drainage bag (all brands) $10.00
**Code = A4561 Pessary $60.00
**Code = 54235 Corpora cavernosa injection $322.00
**Code = J3490 Testopel pellet (1) $125.00
**Code = J1071 Testosterone $0.17 per mg
**Code = A4217 One (1) liter sterile water or NS $10.00
**Code = J1580 Gentamicin 80 mg $66.00
**Catheter secure $5.00
**Blue icicle meatal dilator $42.00
*Note 1: For MOST medical items, we can ONLY provide it to you if paying in full when you receive the item since we cannot bill insurance. No discount is available for these services.
**Note 2: If your are a Medicare beneficiary (and other insurance programs may apply), you will be required to complete/sign an Advance Beneficiary Notice of Noncoverage (ABN) form since Medicare payment is expected to be denied. The ABN is issued in order to transfer potential financial liability to the Medicare beneficiary in certain instances (Please see the following for more information on ABNs from Medicare: https://www.cms.gov/medicare/medicare-general-information/bni/abn.html).

Sildenafil
Service Price
20 mg, 10 tabs ($0.45 per tab) $4.50
20 mg, 30 tabs ($0.45 per tab) $13.50
20 mg, 90 tabs ($0.45 per tab) $40.50
100 mg, 10 tabs ($1.00 per tab) $10.00
100 mg, 30 tabs ($1.00 per tab) $30.00
100 mg, 100 tabs ($1.00 per tab) $100.00
Pill Splitter $3.00
Note: We can ONLY provide you with Sildenafil if paying in full when you receive the medication since, in most cases, we do not bill insurance for Sildenafil.