I believe my out of pocket expense, while I was covered by my work insurance, was my $20 co-pay. This year as a retired person, I had to pay $650. 

As this is an optional procedure, but a life-saving one, I wonder how many men will forgo this procedure due to the cost?

Paying for routine care is not insurance. It is prepaid healthcare. Prepaid healthcare will always be more expensive than just paying cash because you have the administrative fees built into it.

Insurance should be between the patient and their insurance company only. The patient pays the doctor, then the patient gets reimbursed by the insurance. Making it a transaction between the doctor/hospital and insurance removes the patient from the moral hazard of the economic decisions.