This is medicine in the USA. A business for profit. I’m certainly not advocating for socialized medicine but our cost exceed every country in the world. I shopped around when deciding my empty scrotum needed to go. I found a doctor who had reasonable fees and the surgery was preformed in her office (she has a surgical suite just like a hospitals). She does all manner of cosmetic procedures there and specializes in SRS including lots of orchiectomies. $1200 for the scrotum removal and I think an orchi is the same price. The shame is that so few surgeons offer elective orchiectomies shopping around can be a challenge. Now it was cash only but you can file with your insurance if they will pay. In my case my insurance would have paid 50% of the $6000 quoted by my urologist so I actually saved money on the copay. I loved the doctor and her staff as well as the office and they really make you feel at home, not like a hospital.