Aquablation for an enlarged prostate typically costs between $10,000 and $15,000 in total hospital charges, though your actual out-of-pocket expense depends heavily on your insurance coverage and where the procedure is performed. A European hospital cost analysis found the average total cost per patient was approximately EUR 11,000 (roughly $12,000 USD), which included the procedure itself, the robotic equipment, anesthesia, and any overnight stay.
What Drives the Cost
The biggest factor behind Aquablation’s price tag is the technology itself. The procedure uses a robotic system called AquaBeam, which combines real-time ultrasound imaging with a high-pressure waterjet to remove prostate tissue. Hospitals pay for the disposable probe and access to the robotic platform on top of standard surgical costs like operating room time, anesthesia, and staffing. That equipment cost is baked into your bill.
Facility type also matters. Aquablation is most commonly performed in a hospital setting because it requires general anesthesia and specialized imaging equipment. According to Johns Hopkins Medicine, most patients spend two to three hours in recovery afterward, and some stay overnight while others go home the same day. An overnight stay adds room charges, nursing care, and monitoring costs that a same-day discharge avoids.
How It Compares to Other BPH Procedures
Aquablation consistently costs more upfront than the traditional gold-standard surgery, TURP (transurethral resection of the prostate). In a published hospital cost analysis, Aquablation averaged about EUR 11,000 per patient compared to lower figures for TURP at the same institution. A separate four-year cost comparison presented at an international health economics conference found a similar pattern: Aquablation was the most expensive option at roughly 42% more than HoLEP (laser enucleation) and about 28% more than TURP when factoring in both the initial procedure and follow-up care over four years.
Here’s how the major surgical options ranked in that four-year cost model:
- HoLEP (laser enucleation): Lowest total cost, partly because retreatment rates are very low
- Water vapor therapy (Rezūm): Similar cost to HoLEP, though it works best for smaller prostates
- TURP: Mid-range cost, still widely performed
- PVP (GreenLight laser): Similar to TURP
- Aquablation: Highest total cost over four years
That said, cost comparisons don’t capture the full picture. Aquablation’s main clinical advantage is that it can treat very large prostates (over 80 grams) while preserving sexual function at higher rates than TURP. For men with large prostates who prioritize avoiding ejaculatory side effects, the added cost may reflect a tradeoff they’re willing to make.
Insurance Coverage
Aquablation has an FDA clearance and its own billing code (CPT 52597), which means most major insurers now recognize it as a covered procedure for BPH. Aetna, for example, lists Aquablation as a medically necessary alternative to TURP for members with benign prostatic hyperplasia who meet standard clinical criteria. Other large insurers have followed a similar path as the procedure has gained wider adoption since its FDA clearance.
If your insurance covers it, your out-of-pocket cost comes down to your plan’s deductible, copay, and coinsurance structure, just like any other inpatient or outpatient surgery. For someone with a typical employer-sponsored plan who has already met their deductible, out-of-pocket costs might range from a few hundred to a few thousand dollars. If you haven’t met your deductible, you could be responsible for a significantly larger share.
Before scheduling, ask your urologist’s office to obtain prior authorization and request a predetermination of benefits from your insurer. This gives you a written estimate of what the plan will pay and what you’ll owe. The hospital’s billing department can also provide a cost estimate based on your specific insurance.
Costs You Might Not Expect
Beyond the procedure itself, plan for a few additional expenses. Anesthesia is billed separately from the surgeon’s fee and the facility fee, so you may receive three distinct bills. If the anesthesiologist is out of network even though the hospital is in network, that can create a surprise charge, though federal No Surprises Act protections limit this in many cases.
Post-procedure, you’ll likely go home with a catheter for one to three days. The catheter removal visit is usually a quick office appointment, but it’s a separate charge. Most men also have a follow-up appointment a few weeks later. Prescription costs are minimal since recovery typically involves short courses of standard medications for pain and bladder spasms.
One longer-term cost consideration: because Aquablation is a newer procedure, the data on how often men need retreatment years later is still maturing. Older procedures like HoLEP have decades of data showing very low retreatment rates. If a second procedure is eventually needed, that’s a significant additional expense. The four-year cost models already account for some of this, which is part of why Aquablation’s total cost over time remains higher than alternatives.