Do you have an HSA plan? what's your co-insurance coverage like? i'm assuming that's where the extra expense is coming from? so if your deductible is 3500, that means the remaining 11,500 is from your co-insurance, which if there is any at all, it's usually 20% for you. that means the surgery and all the other crap would total out to $61,000 (assuming i'm correct about the co-insurance part). if I'm wrong about the co-insurance, why would you have to pay for anything beyond $3500? i'm self employed, but am covered by my wife's plan (she works for a large corporation, with excellent benefits) so I'm not too worried about it, but i know people with HSA's with supposedly 100% coverage on co-insurance so I'm curious.