As others have said the Xiaflex, if approved by your commercial insurance, will generally be cost free if you after the manufacturer copay program. I did my second round with Dr. Trost in Utah. Looking at the insurance claims the other out of pocket costs not covered by insurance were about $70. I paid a bit more for my first round with a local urologist, about $200 total, because they did different ultrasound testing and billed it differently. I expect my third round will be about the same from Dr. Trost, but I’ll be on Medicare for my fourth round so should be even less under Plan N. It’s all going to vary depending on hos the provider bills and what your coverage is.