I had my lap band surgery on April 4th, 2011 as a "cash upfront" customer.. I was warned upfront that if I have a hiatal hernia, that it would be repaired, and that my insurance would be billed, and that if insurance did not pay up, that I wouldn't have to pay for the hiatal hernia repair. I just received an "Explanation of Benefits" from my insurance company, and it appears that the Doctor/Surgery Center billed my insurance company over $20,000 for the hiatal hernia repair (I confirmed this with the billing office). It appears that my insurance company has already paid approximately $8800, which is in addition to the $9900 I paid upfront. And from what I understand, the repair of the hiatal hernia did not require any additional supplies or extended stay. I can understand them billing for some additional charges, but these charges seem excessive, and possibly "double dipping", i.e. billing the insurance company for things that I already paid for when I paid cash for the surgery itself. I'm concerned that my insurance company may raise my rates or even possibly drop me as a client. I'm not sure if I should contact them about this. But I think I understand now why lap band surgery is growing, and there are billboards everywhere. The ability to add several thousand dollars of profit to every transaction makes this an extremely lucrative practice..