There needs to be a way to post the full fee to the patient's ledger while factoring the patient's co-insurance from the reduced PPO fee. If the patient's insurance changes, if they have dual insurance, or if the procedure isn't eligible for a PPO discount, it is awkward to go in and make a "misc adjustment" to the ledger to account for the fact that the full fee applies. Being able to post the full fee without factoring in the PPO discount creates a barrier to care, as their co-insurance is not accurate.