When suffering from an injury, accident victims have to deal with numerous challenges. Among them is paying for the medical bills associated with the injury. More often than not, medical bills resulting from a personal injury are extremely costly. This is especially true for serious or chronic injuries.

It doesn’t help that hospitals and insurance companies often exacerbate a victim’s frustration and worry. Dealing with insurance companies and hospitals in order to pay for medical care can be an exercise in futility. Frequently, victims are left holding a massive bill for treatment whose cost they couldn’t possibly have estimated going into the hospital. Rarely is the patient informed in advance of what a treatment is going to cost them—something so important, especially to those whose injury prevents them from working and earning a living.

A recent study of hospitals in Alabama and other states in the U.S. has found that what hospitals charge for the same services can vary widely. The study looked at what 3,000 hospitals across the country charge for the top 100 Medicare inpatient stays most often billed.

According to the study, the costs of some of the same treatments varied into the thousands. To get a heart pacemaker implanted at St. Vincent’s Birmingham, for example, you might pay the average cost of $26,786. At Trinity Medical Center, however, you might pay $92,639.

If you have insurance, you likely wouldn’t pay the full cost, as insurance companies negotiate with hospitals to lower the amount of the charges. But if you don’t have insurance, you can expect to be stuck paying the full amount.

“The complex and bewildering interplay among ‘charges,’ ‘rates,’ ‘bills’ and payments across dozens of payers, public and private, does not serve any stakeholder well, including hospitals. This is especially true when what is most important to a patient is knowing what his or her financial responsibility will be,” said American Hospital Association President and CEO Rick Umbdenstock.

This study underscores the importance of asking in advance what your medical care is going to cost you so that you prepare your finances accordingly.