I'm going to make this short as possible - My husband suffered a stroke and at the time we had a premium PPO insurance plan. It wasn't far from our house, however the Ambulance did take him to the ER. He was hospitalized for 2 days. Our final bill was $24,000 and change, this was after our Insurance had paid there coverage. We had a hard time (took us 2 months) finding out what the total actual cost was. We ended up negotiating the bill down from the 24k, because we started researching the medical cost in a few other facilities nearby, and what we found completely blew our minds. I will say these were estimates, however the overall costs were roughly 70% less. Sure, other factors come into play such as specialization, experience in medical providers etc, but If you're going to charge that much more at least provide some reasoning as to why the medical procedure cost is what it is .