Negotiate, negotiate & negotiate...
Times are tough and nothing is cast in stone. I say negotiate. Maybe arrange a meeting with the hospital administrator and say look I'll pay the $11,000 but the additional $25,000 is just too much. It only makes sense to do two levels, so I'll either have to go overseas and have the two levels done there, where the disc costs less and the labor too or have two levels in the states on a cost competitive basis. I would offer $23,000 for the patient out of pocket part or tell them I am going elsewhere. It's free to ask.
If you can't stomach $23k, then offer what you can afford.
It just does not make sense that the second disc will have labor costs of $25,000 because it is only taking about another 20 minutes.
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