The fun part is that they probably didn’t! My insurance is actually pretty good, so all I pay is a $250 copay for each surgery. My insurer now gets to pay for the time of two surgeons, two anesthesiologists, and the multiple nurses involved (at least 8, between pre-op, procedure, and recovery). Plus all of the other costs. So at least I get the knowledge that it probably cost them an extra $15k.