I didn't have to pay $1,000 up front, but I did have to pay about $150 for appointments before I could even be considered for insurance approval. My insurance did cover my surgery, but I know that it will not cover any of my fills, which will probably cost at least $150 per fill. Assuming that some of your money is refundable if you do not get covered by your insurance and decide not to continue with the surgery, $1,000 does not seem out of the realm of possibility of what you could expect to have in bills for things insurance won't cover, especially with the membership to the hospital's fitness center thrown in. Does that make sense? I'll end up spending a lot on fills, except I'm not paying it all up front at once. If you can get the money together, it would be kinda cool to not have to worry about paying for any of your fills or shakes or vitamins later on. Good Luck!!