General insurance questions-Deductible

Ok I am a bit confused here. Do you pay the deductible up front? Or do you pay it when you get all the bills? The way I think I understand it is this; you have the surgery, you get billed for surgery, they add your deductible to what you owe. Is that right at all? I would like to know because I want to see how much $ I may need beforehand. Thanks for your help guys!!:)

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