Apatient with a high-deductible consumer-driven health plan has met half of the $1,000 annual deductible before requiring surgery to repair a broken ankle while visiting a neighboring state. the out-of-network physician’s bill is $4,500. the ppo that takes effect after the deductible has been met is an 80-20 in-network plan and a 60-40 out-of-network plan. how much does the patient owe? how much should the ppo be billed?