I recently had ACL surgery performed on my 7 year old Rottweiler. The procedure cost me $4500. and VPI reimbursed me only $1500. I expected much more. Their expectation of what the procedure should cost is totally unrealistic. I couldn't have had it done at COSTCO for the price they felt was fair. This isn't 1982 anymore it's 2012 and medical procedures are much more expensive. I asked them to recommend a Vet to me who charged the prices that VPI indicated a precedure should cost and they couldn't and I can see why.