We read the article by Dr Hsia and colleagues,1 as well as the related publication in the New York Times,2 with great interest. This article illustrates important concerns about charge variability in health care. A median charge of $33 611 is notably high, and a range from $1529 to $182 955 is extraordinary. However, we believe the article may somewhat overstate the scope of the problem, at least in the specific case of acute appendicitis. We would like to draw attention to several areas that would benefit from additional discussion.