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For a double orchiectomy you'd think they could sell it as a two-in-one deal, no?
But really where does the expense come from? We've been performing castrations for centuries now, the most modern thing is the analgesic they give you during the operation, is it that expensive?
Mine certainly wasn't itemized like this, and ya, the anesthetic is probably the most modern part, maybe the vicryl sutures. The expense comes in because the surgeons time is valuable and a finite resource.