Do most hospitals require 100% of ins. copay upfront?

My insurance has a $500 deductible which is now met. After the deductible, I am responsible for 20% of costs for surgery up to the breakpoint. I was told at the doctor's office that since it is an "elective" surgery I would have to pay everythigng upfront. Is it the same at all hospitals or can they work with you? I have over 50% to pay now......Any suggestions are appreciated.

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