STEP 11: Investigate Testosterone Therapy Options that You Can Afford:
Okay, so you have weighed The Benefits of Testosterone Therapy versus the The Risks of Testosterone Therapy, discussed with your doctor and decided to proceed. If so, you may be fortunate enough to be in the situation that I am in, where your TRT (Testosterone Replacement Therapy or HRT) is largely covered by insurance. However, not all of us are so fortunate. And some of us could be covered by insurance, but the physicians and/or protocols are so lousy that we choose to go to a doctor more proficient and knowledgeable. For these and many other reasons, some men would like to know the cash cost and least expensive ways of going on TRT.
Below I am going to cover what I consider to be some of the more reasonable and reliable testosterone replacement options out there to do this. Of course, if you want to spend more and go to a good anti-aging doctor, the sky is the limit on what you can spend. Again, here are Six Lower Cost Options for HRT Available to Men that I know about from running the Peak Testosterone Forum:
NOTE: I did not discuss HCG Monotherapy or Clomid below, but these are also relatively inexpensive options for men to consider. See my STEP 6: Alternative Strategies to Raise Testosterone.
1. Local Doctor with Compounded Testosterone. Every PCP and urologist will have worked with a compounding pharmacy in the past for a variety of reasons that involve some individualized patient therapies. Although not very well-known by the public, this is actually surprisingly common and the practice allows doctors to somewhat customize certain treatments for their patients. For example, the urologist that did my TRT a few years ago used this strategy when Androgel just did not raise my testosterone levels. Basically, compounders can add bioidentical testosterone to a cream or gel - can you say Barry Bonds? - that increases absorption through the skin. Concentrations vary from about 1 to 10% and are usually very effective at raising testosterone, assuming your physician knows what he/she is doing.
My compounded testosterone was run through insurance, but I do know it was less than $100 per month even without insurance. And this was verified by one of our senior Peak Testosterone Forum members, who said that he spent $75 per month. 
NOTE: I have no current affiliation with any of these providers.
2. Local Doctor with Testosterone Cypionate Injections. This is my most recent strategy. Basically, I used an HRT clinic to get on testosterone cypionate and then found a PCP that was willing to continue with the same protocol. It worked quite well, except my doctor will not do HCG (for restoring testicular volume). So, in my case, I have a nice cypioante protocol (subQ or subcutaneous self-injections) run through insurance. I pay a $40 copay for a supply that lasts two or three months.
If you do not have insurance, testosterone cypionate injections are not expensive and generally run for about $100 per month (or often less) including syringes and needles if you are self-injecting. This is the most popular option on our forum as you can see in this Peak Testosterone Forum Treatment Poll and accounts for about 50% of all men on some kind of testosterone replacement therapy, including HCG and Clomid.
3. Out-Of-State Consults with Dr. Eugene Shippen. Dr. Shippen is one of the early pioneers of HRT and some of you may recognize the name from his classic book The Testosterone Syndrome. I have had a number of men actually visit Dr. Shippen and/or have a phone consult with him and have yet to hear a negative report. He is known for being thorough and one of the things that I like about him is that he tries to stay physiological from all I can tell. He likes to mimic, as much as possible anyway, the natural rhythms and levels that the body can achieve on its own for maximum safety and a more natural approach.
Here is an description coming from one of our seasoned posters:
"I'd say his reputation is well deserved. He is a really nice guy and very easy to talk to. Before seeing him I had to write a letter explaining my history and why I was coming to see him. My letter ended up being quite lengthy because I had already been to several TRT docs and tried several forms of treatment. In my 2 hour discussion with him it became apparent that he actually read, no, I would say studied, my letter because he actually referred back to comments that I had made in it. Most doctors I've seen don't look at my records until after they walk into the exam room. The jury is still out as to whether he can actually help me or not, but I none of the other docs I've seen any idea what to do or try." 
One of our seniors members has had a particularly good experience with Dr. Shippen and chronicled his experience here in my page on Daily HCG Injections. Below he broke down Dr. Shippen's costs, although remember that you must call speak with his office to get an estimate that corresponds with your exact situation:
"Dr. Shippen uses Compounding Pharmacies so it is MUCH cheaper:
-- My first visit was $600. He spent 2 hours with me and went over all labs, and did a checkup including the prostate.
--Yearly visit = ~$350 unless you requested additional prescriptions (government requirement)
--Testosterone Cypionate 200MG/10ML Yearly Cost = $140.
--HCG Yearly Cost = $150
--AI .1mg. troche = 80.00 (use as needed, per labs)
Syringes from Walmart $12 per 100 count Pure Encapsulations
--Vitamin D3 5000iu, 120 count = $27.00 (all these from amazon)
--Pure Encapsulations DHEA 25mg. 180 count = $35.00
--Pure Encapsulations Pregnenolone 30mg. 180 count = $34.00" 
Also, labs were around $185 according to one poster with Dr. Shippen and were reimburseable through his insurance.  Of course, I am sure lab amounts can vary considerably.
4. Defy Medical with Drs. Sata and Crisler. One of the other apostles of testosterone therapy has been Dr. Crisler. He has a large forum and site (AllThingsMale) that has helped I am sure literally thousands of men get back on their feet. Several forum members have used Dr. Crisler and Dr. Sata and are huge fans of the clinic they are associated with (Defy Medical). One of the big advantages that I see in men going to Defy is a certain amount of low cost customization for specialized situations. For example, we had young poster in his 20's with solid testosterone numbers but high SHBG, which means low free and bioavailable T, who went to Dr. Crisler. He was initially disappointed, because Dr. Crisler would not put him on HRT (due to his age and testosterone levels) and, instead, put him on lower dose HCG coupled with DHEA. To his pleasant surprise, he felt much better within a week or two and Dr. Crisler's approach also kept his fertility and testicular function alive and well. Dr. Sata also has a good reputation on the forum as well.
What are the costs? Well, that will very much depend on your situation, but to give you a rough idea, the poster above who was placed on HCG and DHEA wrote the following:
"Yes because I'm going to use them. Their fee's are $150 for their initial blood work. Then $150 for the hour phone consult with Dr Saya then every 6 months you do another round of bloodwork and another consult with either Dr Saya or his nurse. $65 and $45 respectively." 
My understanding is that they can also give you proper paperwork, so you can file claims with your insurance in some cases.
5. Low Testosterone.Com. This site basically hooks up patients arriving from search engines with local physicians who are willing to treat for a treatment cost of $199 per month. My understanding is that this includes all the costs of the standard "Trifecta" treatment plan, meaning testosterone cypionate injections along with HCG and Arimidex (if needed). Also packaged are testing and monitoring. Comments on the forum have been generally positive and a couple of guys are using their doctor's successfully. One disadvantage for some men: they do not work with insurance. (Please verify all details with the actual provider.) In addition, according to one of our members, there are small copays and some costs for "vitamins and supplies."  One of the moderators for our forum laid out his costs exactly:
--Monthly fee of $200, and $15 per prescription refill
--Cost includes 2 sets of complete bloodwork, doctor visit, all medications (testosterone cypionate, hCG, AI if necessary), all injection supplies, and access to doctor via online messaging."
One thing you should ask about is what happens after the phone consult. One former moderator wrote that "I was told that if after the initial consultation and tests you decided you did not want to pursue their services they would charge you for 3 months (minimum), that is if your blood tests show you qualify. If your blood tests show you do not qualify they refund your money." 
6. Body Logic MD. These clinics tend to be a little costly. However, service provided may be slightly greater in some cases. For example, one of our senior posters (and the only man I know to reverse low SHBG naturally) wrote:
"How does the quality of the consultations compare to what we saw from BodyLogicMD where you pay $495 for the 1st and $295 for the follow up consultations. Think the costs associated with BodyLogicMD where roughly $2500 but all ok don't think this included HCG or anastrozole. I've consistently seen the cost for these programs to be about $3000 annually." 
7. Tom Rogers. One of our posters (Augtrane) really likes his physician and wrote the following:
"Hope this helps for anyone in the Southern Appalachians. I see Dr. Tom Rogers, he's great and so is his support staff, at least at the Kingsport, TN office. He has two other offices, Knoxville and Chattanooga, TN that are primarily run by nurse practitioners, not a bad thing, just don't know them personally. I think Dr. Rogers visits the satellite offices once a week (?) for initial consults and such. He's been very helpful to me. He specializes in hormone replacement therapy and has won "awards" from the state of TN. He's also a great all around physician, I see him as my PCP as well, I feel like that has been beneficial."
"His office is self pay only but his rates are reasonable (insurance may pay for labs and rx's?), approximately $130 for an initial Hormone consultation, $80 for follow-ups. They don't mark up for labs, just a phlebotomist fee (under $10). Injections in office are $35 a piece and he'll likely start you on weekly doses, he'll accommodate other dosing schedules if you ask, I do e4d. Once he gets you on the right dose he'll write you a prescription to do injections at home if you want, I do, it's MUCH cheaper. I know he also does Clomid and HCG and is familiar with AI's. Oh, and he takes out of state patients. Here's a link to his webpage: Performance Medicaine" 
COST OF INJECTION SUPPLIES and CYPIONATE: I don't shop around and get my syringe/needle combinations for around 20 cents each. However, one poster wrote that "you can buy a box of 100 syringes + 100 larger draw needles for about $30 total."  And the cash price of cypionate is about $100 for a 10 ml vial, which is 2000 mg or about 20 weeks of therapy for the typical guy.
NOTE: The prices in this article pertain to the U.S. only. Unfortunately, many countries in the world are tightly controlled by endocrinologists, who almost universally do not like HRT and severely limit options except in the most extreme of cases. In these countries, where there is an almost monopolistic control over men's hormones, options are very limited, testing is scarce and prices are much higher than listed on this page. The U.S. was like this around 10-15 years ago, but, fortunately, the urologists came to our rescue and opened the doors for more well-rounded men's health options for us. (I had a miserable time getting testosterone. See my My Health Story if you are interested.)