Do you have any idea how many goats you can buy in Costa Rica for $450?
When I had my inner ear surgery in 2005, it was to remove a cholesteatoma, a skin-like growth. Once the doc had things opened up, he found that the two tiny bones that transmit sound--the malleus and the incus--had disintegrated to almost nothing. He rebuilt them using artificial bone.
If I'd just gotten a quote from him for the cholesteatoma, what should he have done when he saw the condition of those two bones? Just asked me after I'd come out of the anesthetics if I wanted to have another surgery to rebuild those bones?
When my dad had bypass surgery, they found other things that needed repair.
It's not like replacing shock absorbers or putting caps on teeth.