[Johnny555]

My veterinarian manages to give quotes - before they do emergency treatment, they come up with a low, typical, and high quote, and I have to agree to pay up to the "high" price before they'll start the treatment (if I refuse, then they'll come up with an alternate, possibly less effective, treatment plan.

It's a little harder to do that with humans since they aren't going to pause an operation, keep the incision open, and tell the spouse "We found an unexpected tumor, so let's wait an hour while we generate a new quote and you can decide if you want to pay it".

But that should be part of the quote "Unexpected events can cause us to exceed the quote", and then they should have to document why it was unexpected.