I had been working on my letter when the OP posted that letter but hadn't sent it yet. I was glad that her letter was similar to mine. I did put a paragraph about costs in there - even with average costs of uncomplicated and c-section births in our area. And then my midwife's fees and what they include. (I even included c-section rates to show that if I was at lower risk of a c-section by using my midwife, they chances of them having to pay for a c-section are much lower.)
If something higher-tech is medically necessary, wouldn't a lower-tech option HAVE to also be medically necessary, by definition? I'm not asking for a MORE expensive service. Sheesh.