I read it that if it was the procedure they had planned on all along, the insurance company would've paid their full responsibility.

But when the piercing was added to the bill - the insurance company probably (and I'm just reading into this, because the info in the article is limited) decided that they would pay half of the hospital expenses, half of the anesthesia expenses, etc., because only half of the surgery is what they cover - not the piercing.

So I read it that without the piercing, the insurance would've paid more. But with the piercing, they are dividing their responsibility and pushing some of it back to the patient.

Which is probably "fair". But I'm sure she would've liked to know that going in.