You can hear fine on your right side. Your left ear is gone — completely. Every car that passes, every person who speaks from your left, every grandkid who tugs your sleeve on that side — nothing. The American Academy of Audiology estimates roughly 60,000 Americans develop single-sided deafness each year. For most of them, the question isn’t “do I need help?” It’s “which device actually works for my situation — and what does it cost?”
CROS and BiCROS hearing aids are the two main non-surgical options. They’re not the same thing, and picking the wrong one wastes money and time.
CROS vs. BiCROS: What’s the Difference?
CROS stands for Contralateral Routing of Signal. A small microphone sits on your deaf ear and wirelessly sends sound over to a receiver on your hearing ear. Your good ear does all the work. A CROS system only makes sense if your hearing ear is essentially normal — no amplification needed there.
BiCROS is for people who have one unaidable ear and some hearing loss in their better ear too. It routes sound from the deaf side AND amplifies it before sending it to the aided ear. Most adults over 60 with single-sided deafness end up in BiCROS territory — age-related hearing loss has already taken a toll on the better ear by then.
| System Type | Typical Cost (Both Units) | Best For |
|---|---|---|
| CROS (basic) | $2,000–$3,200 | Normal hearing in better ear |
| CROS (premium) | $3,200–$5,000 | Normal hearing + advanced features |
| BiCROS (basic) | $2,500–$4,000 | Mild–moderate loss in better ear |
| BiCROS (premium) | $4,000–$6,000 | Significant loss in better ear + top tech |
| Bone-anchored device (BAHA/Osia) | $5,000–$15,000+ | Surgical alternative |
Both systems come as a pair of devices even though only one ear does the hearing. That’s why prices are always quoted per pair.
What You’re Actually Paying For
The two units aren’t equal. One is a transmitter (worn on the deaf ear), the other is a receiver and amplifier (worn on the hearing ear). The receiver side is the more sophisticated piece — it’s essentially a full hearing aid. The transmitter is simpler.
Major brands offering CROS and BiCROS systems include Phonak, Signia, Starkey, and Widex. Phonak is widely considered the market leader for single-sided deafness, partly because of its extensive streaming capabilities and research base.
Phonak’s CROS Paradise series is the most commonly prescribed CROS system in the US. Retail pricing typically runs:
- CROS P 50 (entry): ~$2,200–$2,800 per pair
- CROS P 70 (mid): ~$3,000–$3,800 per pair
- CROS P 90 (premium): ~$4,200–$5,000 per pair
Costco carries Phonak products but does not currently offer CROS systems. You’ll need a licensed audiologist clinic for this fitting.
Fitting a CROS or BiCROS system takes more than a standard hearing aid fitting. The audiologist has to verify the system is correctly routing sound and calibrate the gain on your better ear. Plan on 2–3 appointments before it feels right.
Insurance, Medicare & VA Coverage
Medicare Part B does not cover CROS or BiCROS hearing aids. Original Medicare doesn’t cover any hearing aids — a gap that the NIDCD and AARP have both flagged in their advocacy work.
Medicare Advantage plans vary. Some cover hearing aids up to a set dollar amount (often $500–$2,500 per ear, annually or every two years). Call your plan’s hearing benefit line and ask specifically whether CROS systems qualify — some plans classify the transmitter unit differently than the receiver.
VA benefits are a strong option for veterans. The VA provides CROS hearing aids at no cost to eligible veterans with service-connected hearing loss. The VA is one of the largest purchasers of Phonak CROS devices in the country.
Private insurance occasionally covers part of the cost with documentation of medical necessity. Your audiologist can write a letter of medical necessity — ask for this before submitting any claim.
Don’t confuse CROS hearing aids with bone-anchored hearing devices like the Cochlear Baha or Osia systems. Those require surgery and cost $5,000–$15,000+, but may be covered differently under insurance as a “prosthetic device.” If your audiologist mentions both options, ask which billing codes each would use before you decide. See our guide on bone-anchored hearing aid cost for a full comparison.
Do They Actually Help?
Research published in the International Journal of Audiology found that CROS hearing aids significantly improve speech understanding in noise for people with single-sided deafness — which is the biggest complaint this group has. Most users report a 2–4 week adjustment period before the brain starts integrating sound from both sides naturally.
If you try a CROS system and it isn’t enough, surgical options like bone-anchored devices or cochlear implants are the next step. Cochlear implantation for single-sided deafness expanded considerably after FDA approval in 2019 — see our cochlear implant cost guide for what that path looks like financially.
Bottom Line
A CROS system runs $2,000–$5,000 per pair; BiCROS runs $2,500–$6,000 depending on technology level. Medicare won’t cover them, but VA benefits often do for eligible veterans. If your better ear also needs amplification, BiCROS is the right conversation to start with your audiologist. Always request a trial period — most practices offer 30–60 days — before committing to any device.