Gary or anyone help, have not seen this problem here

I was pre approved for surgery and had talked to the hospital about payment as my surgeon was in network but the only hospital in town that does a lapband was out of network. The hospital agreed to work with me and accept the insurance payment as full payment in the event they didn't cover the surgery at 100% because they were out of network. The EOB's coming in say that insurance is paying the hospital at 100% but here is the problem... The hospital has billed me $15,280.35 for the surgery. United Health has paid the hospital a total of $3,656.95. The remarks on the EOB state that the charge has been reduced by the amount that is above the usual reasonable and customary charge for my area as determined by the outpatient surgical facilities charge index.. It gives me a phone number to call if the hospital charges me the remaining $11,623.40. It also says charges exceed your contracted/legislated fee arrangement. ANSI Code: PR45. The hospital sent me a bill for the remaining $11,623.40. I phoned the number on my EOB and reached a company that handles appeals for United Health. They said they will submit an appeal and see if the hospital will write off the remaining $11,623.40. She said there is no guarantee. I am now worried about what I will owe. Having worked as a nurse for too many years to count I am fully aware that even if the hospital performed the lapband surgery at cost, it would come to more than $3,656.95. I know I need to wait for this company hired by my insurance company to file the appeal but this seems like a huge amount not to be covered. I checked with both the insurance company and the appeals company and they do have an itemized bill with codes for the operating room, etc. They both said they didn't need me to ask the hospital for further supporting documentation. I'm thinking something doesn't seem right here but I don't know exactly what. Can anyone help? Thank you, Nancie

Please email me privately.