Part of: Starting TRT

TRT cost: what labs, visits and prescriptions cost

What TRT costs in the US, with dated public prices for testosterone, blood tests and visits, how insurance changes it, and what nobody publishes.

By TRTracker editorial team · Updated October 21, 2026
Sources checked by the TRTracker editorial team · Review by a clinician in progress

A man in glasses and a plaid shirt talks with a woman across a kitchen table covered with papers, a laptop and coffee mugs.

TRT cost is drug plus labs plus visits plus fees; generic injections are cheap, brand products and online plans are not.

Ask for the price per mL and per test
Check prior authorization before the first fill
Budget for blood tests at least yearly
Compare a local prescriber with an online plan
Never skip monitoring to save money

Medicaid National Average Drug Acquisition Cost (NADAC), 2026 dataset (Centers for Medicare and Medicaid Services) (Centers for Medicare and Medicaid Services)
Medicare Part D Spending by Drug (Centers for Medicare and Medicaid Services, data for 2020 to 2024) (Centers for Medicare and Medicaid Services)
Clinical Laboratory Fee Schedule files, 2026 (Centers for Medicare and Medicaid Services) (Centers for Medicare and Medicaid Services)
Physician Fee Schedule relative value files, 2026 (Centers for Medicare and Medicaid Services) (Centers for Medicare and Medicaid Services)
Testosterone testing in the United States: limited price transparency and significant variability (DeMasi et al., Int J Impot Res 2026) (International Journal of Impotence Research)
Practice Comparison and Cost Analysis of Direct-to-Consumer Telemedicine Platforms Offering Testosterone Therapy (Jesse et al., J Sex Med 2022) (Journal of Sexual Medicine)
Medicare.gov: Costs for Medicare drug coverage (Centers for Medicare and Medicaid Services)
Medicare.gov: Diagnostic laboratory tests (Centers for Medicare and Medicaid Services)
Medicare.gov: Drug plan rules (prior authorization, step therapy) (Centers for Medicare and Medicaid Services)
HealthCare.gov glossary: Prior authorization (HealthCare.gov)
Aetna Clinical Policy Bulletin 1014: Androgens and anabolic steroids (last reviewed July 2026) (Aetna)
Cigna Coverage Policy IP 0351: Testosterone injectable and implantable products (effective October 2026) (Cigna)
FDA: Testosterone information (June 2026 labeling update) (U.S. Food and Drug Administration)
21 CFR 1306.22: Refilling of prescriptions (Schedule III and IV) (Electronic Code of Federal Regulations)
Fourth Temporary Extension of COVID-19 Telemedicine Flexibilities for Prescription of Controlled Medications (DEA and HHS, Federal Register 2025) (Federal Register)
IRS Publication 502: Medical and Dental Expenses (2025) (Internal Revenue Service)
VA Criteria for Use: Testosterone replacement in males (updated March 2025) (U.S. Department of Veterans Affairs)

Updated October 21, 2026

How much does TRT cost?

TRT cost isn’t one number. It has four parts: the testosterone itself, blood tests, prescriber visits, and any clinic or membership fees.

For generic injections, the drug is usually the cheapest part. For brand products and many online plans, it isn’t.

Every price below comes from a public source, and each one has its date. Where no public price exists, we say so. If you’re new to treatment, our starting TRT guide covers the whole path.

Part	Public benchmark	Date
Testosterone cypionate (generic)	About $3.52 to $11.01 per mL paid by pharmacies, depending on vial size	October 2026
Brand gels, autoinjector, capsules	$788 to $1,148 average Medicare spending per fill	2024 data
Total testosterone test	$25.81 Medicare rate; $84.90 median hospital list price	2026
Prescriber visit	About $95 to $136 Medicare rate for a routine follow-up	2026
Online clinic, 12 months of injections	$1,586 to $4,200 in one study of three clinics	2022

These figures come from Medicare and Medicaid price data, plus a 2026 study of hospital price lists and a 2022 study of online clinics. They are benchmarks, not what you will pay.

Your cost depends on your insurance, your pharmacy, your lab and where you are treated. Use them to know what is reasonable and what to ask.

What does testosterone cypionate cost?

Pharmacies paid about $3.52 to $11.01 per mL for generic cypionate in October 2026. The best public price is NADAC, a Medicaid survey of what pharmacies pay to buy each drug.

As of October 21, 2026, the price for the 200 mg/mL strength was about $11.01 per mL in a 1 mL vial. It was about $3.52 per mL in a 10 mL vial of the same strength.

Enanthate, a similar injectable, cost about $14.48 per mL. These numbers leave out the pharmacy’s dispensing fee and margin, so the price at the counter is higher.

Bar chart of what pharmacies paid per mL in October 2026: cypionate 1 mL vial $11.01, cypionate 10 mL vial $3.52, enanthate vial $14.48. — Pharmacy acquisition cost per mL, October 2026. The price you pay includes the pharmacy's fee and margin. Source: CMS NADAC

Vial size changes the price per mL a lot. The 10 mL vial cost about a third as much per mL as the 1 mL vial.

Which vial suits you depends on your prescription and how long an opened vial lasts. Ask your pharmacist, and don’t change anything on your own.

Prices have fallen. In Medicare data, the average spending per fill of generic cypionate dropped from $52.15 in 2020 to $37.01 in 2024. Over the same years, fills rose from about 772,000 to 1.1 million.

Why do gels, autoinjectors and capsules cost more?

Mostly because many are brand-name products without cheap generics. In 2024, Medicare’s average spending per fill, before rebates, looked like this:

Average gross Medicare spending per fill in 2024. A fill can cover a different number of weeks for each product. Source: CMS Medicare Part D Spending by Drug

Generic topical testosterone (gel) averaged $168 per fill, down from $351 in 2020.

Brand AndroGel averaged $1,148, the Xyosted autoinjector $788 and the oral capsule Jatenzo $1,055.

These figures are for a Medicare population. A fill also covers a different length of time for each product. So compare the rough size of the numbers, not exact ratios.

Cost is a fair part of choosing a form. The Endocrine Society lists it alongside your preference, side effects and how much effort the treatment takes. Our guide to testosterone gel vs injections compares the forms on everything else.

How much do TRT blood tests cost?

Blood tests are a recurring cost. Guidelines call for testosterone, hematocrit and often PSA several times in the first year, then yearly.

Hematocrit is the share of your blood made of red cells. PSA is a blood marker used to watch prostate health. What a lab is paid for each test varies widely:

Bar chart of what one blood test costs: Medicare lab rates in 2026 of $25.81 for total testosterone, $25.47 for free testosterone, $27.94 for estradiol, $18.39 for PSA, $7.77 for a complete blood count and $9.34 for the blood draw, against a median hospital list price of $84.90 for total testosterone. — Medicare pays labs far less than many hospitals list. Ask for the price before the draw. Source: CMS lab fee schedule 2026 and a 2026 study of hospital prices

In 2026, Medicare pays labs $25.81 for total testosterone and $25.47 for free testosterone. It pays $27.94 for estradiol, $18.39 for PSA and $7.77 for a complete blood count. Drawing the blood adds $9.34.

By our math, a monitoring draw of total testosterone, blood count, PSA and estradiol comes to about $89 at those rates.

Hospitals often charge more. In a study of hospital price lists, the median price for a total testosterone test was $84.90. Only about half of 6,700 hospitals published a price at all.

Independent labs and hospital labs can price the same test very differently, so ask first.

Before treatment, the two morning tests needed for a diagnosis add to the cost. Your draw dates matter too. Our draw-date planner shows where each draw falls in the first year.

What does a TRT visit cost?

There is no public cash price list for visits, but Medicare’s fee schedule gives a benchmark. In 2026, Medicare’s national rate for a routine follow-up visit in an office is about $95 for a shorter visit and $136 for a longer one.

A new-patient visit is about $118 to $177. These are our calculations from the published values, before any adjustment for your region.

Visits also recur for a legal reason. Testosterone is a Schedule III controlled substance.

A prescription can’t be filled more than six months after it was written, and it can’t be refilled more than five times. In practice, you will need contact with your prescriber at least about twice a year.

What does TRT cost with insurance?

Insurance changes the total more than anything else, but it comes with rules. Most plans require prior authorization, which is approval before they will cover the prescription. It isn’t a promise to pay.

Plans usually want proof of the diagnosis. Aetna’s policy, last reviewed in July 2026, requires at least two confirmed low morning testosterone levels before you start. Cigna’s policy, effective October 2026, requires two early-morning tests on separate days plus symptoms that persist.

Aetna’s policy still lists age-related low testosterone as unproven. In June 2026 the FDA asked for that limitation to be removed from labels. Plans can lag behind labels.

Public programs are similar. The VA’s 2025 criteria ask for two clearly low fasting total testosterone levels, drawn between 8 and 10 am at least a week apart.

They also ask for baseline hemoglobin and hematocrit, plus LH, FSH and prolactin (other hormone tests). Each test is part of the cost of starting.

Medicare: in 2026, Part D drug plans can have a deductible of up to $615. Then you pay 25% coinsurance until your out-of-pocket spending reaches $2,100, after which covered drugs cost nothing for the rest of the year.

You usually pay nothing for Medicare-covered lab tests. Plans can also use step therapy, which asks you to try a less expensive drug first.

Ask your plan which testosterone products are on its formulary, what the copay is for each, and whether labs are covered in-network.

What does TRT cost without insurance?

This is where public data runs out. We couldn’t find a primary source for the cash price of generic testosterone at a pharmacy counter. We also found none for any online clinic’s current monthly plan, so we don’t quote one.

What you can do is price each part yourself:

The drug: ask the pharmacy for the self-pay price per mL for your exact product and vial size. Compare a few pharmacies.
The labs: ask the lab for the self-pay price of each test before the draw. Hospital and independent lab prices differ a lot.
The visits: ask the practice for its self-pay price for a new and a follow-up visit.
Supplies: syringes, needles, alcohol pads and a sharps container add a small amount.

Prescribed medicines and lab fees that are part of medical care count as medical expenses under IRS rules. That matters if you itemize or use a health savings or flexible spending account. Ask a tax adviser about your situation.

Are online TRT clinics cheaper than a local prescriber?

Not according to the only published comparison.

A 2022 analysis found that 12 months of injectable testosterone cost $1,586 to $4,200 through three online clinics. It cost $134 to $1,333 at one academic medical center, depending on insurance.

The authors found the online clinics largely followed guidelines, but at a higher ongoing cost. The study looked at only three platforms and one center, and prices have changed since.

Online clinics often bundle the drug, labs, visits and supplies into one price, which can be convenient. Compare like with like. Check what is included, what is extra, and whether you could use your insurance instead.

As of October 2026, temporary federal rules allow controlled medicines to be prescribed by telemedicine through December 31, 2026.

What might the first year of TRT cost?

Here is an illustration using Medicare’s 2026 payment rates. It shows how the non-drug parts add up. It isn’t a quote.

Your prescriber decides which tests you need, and your prices will differ.

Item (illustrative)	At Medicare 2026 rates
Two morning total testosterone tests to confirm the diagnosis, with blood draws	$70.30
Baseline extras such as free testosterone, SHBG, LH, FSH and prolactin	$103.68
Two monitoring draws (total testosterone, blood count, PSA, estradiol)	$178.50
One new-patient visit and three follow-up visits	$403.14
Total before the drug and any fees	About $756

Our arithmetic from the 2026 Medicare lab and physician fee schedules. Hospital and self-pay prices can be several times higher.

Then add the drug. For generic cypionate, a year’s supply at pharmacy acquisition prices is a small share of this total.

For a brand gel, autoinjector or capsule without good coverage, the drug can cost more than everything else combined. How long a vial lasts depends on your prescription. Our vial supply calculator helps you estimate it from what you have been prescribed.

How can you lower the cost without cutting corners?

Ask about generics. Generic cypionate is the least expensive form in every dataset we found.
Ask your pharmacist about vial size. The price per mL differs a lot between vial sizes.
Price your labs. The same test can cost several times more at one lab than another.
Use your insurance where you can. Check the formulary and prior authorization early.
Keep your own records. A clear history of doses, labs and symptoms makes visits shorter and avoids repeated tests.

Don’t skip monitoring to save money. Hematocrit, PSA and blood pressure checks are how side effects are caught early. If cost makes treatment hard to keep up, talk to your prescriber. Don’t stop suddenly.

What should you ask before you pay?

What is the self-pay price per mL of my exact product and vial size?
Which blood tests are included, and what does each cost?
How many visits and draws should I expect in the first year?
Does my plan need prior authorization, and is this product on its formulary?
If it’s a bundled plan, what’s included and what costs extra?

Whatever you choose, TRTracker, our free app, keeps your doses, labs and symptoms in one place so each visit counts.

Frequently asked questions

How much does TRT cost per month?

There's no single answer. Generic testosterone cypionate can cost pharmacies only a few dollars per mL, while brand gels and autoinjectors run hundreds of dollars per fill. Labs, visits and any clinic membership fees often cost more than the drug itself. Ask for each part separately rather than one monthly figure.

How much does TRT cost without insurance?

We couldn't find a primary source for cash prices at the pharmacy counter or for online clinic plans, so we don't quote one. Public benchmarks help: pharmacies paid about $3.52 to $11 per mL for cypionate in October 2026, and the median hospital list price for a total testosterone test was $84.90. Ask for the self-pay price of each item before you buy.

Does insurance cover TRT?

Often, with conditions. Plans commonly require prior authorization and two low early-morning testosterone tests before approval, as Aetna's and Cigna's 2026 policies do. Some plans have excluded age-related low testosterone. Your deductible, copay or coinsurance then decide what you pay. Ask your plan which forms are on its formulary.

Are online TRT clinics cheaper?

Not necessarily. A 2022 study found 12 months of injectable testosterone cost $1,586 to $4,200 through three online clinics, compared with $134 to $1,333 at one academic medical center, depending on insurance. Online clinics may bundle convenience, labs and supplies, so compare what each price includes.

How much do TRT blood tests cost?

It varies a lot by where you go. In 2026, Medicare pays labs $25.81 for a total testosterone test, $7.77 for a complete blood count and $18.39 for a PSA test. The median hospital list price for total testosterone was $84.90, with a wide range. Medicare patients usually pay nothing for covered lab tests.

Can I use an HSA or FSA for TRT?

Prescribed medicines and lab fees that are part of medical care generally count as medical expenses under IRS rules, and HSAs and FSAs follow similar definitions. Check your plan's rules and keep receipts, and ask a tax adviser about your situation.

This guide is general education, not medical advice. Talk to your clinician before changing anything about your treatment. Read our medical disclaimer and editorial policy.