Exhibit 4.1 Costs for the Most Frequent Diagnoses

Amount and Growth in Inflation-adjusted* Hospitalization Costs for Six of the Most Costly Cardiovascular Conditions,** 1998-2005

Year	Costs in Millions	Standard Errors in Millions	Percent Growth
1997	$39221.1505	1653.056969
1998	$39096.7019	1529.927579	0.8
1999	$39571.2878	1483.2678	2.7
2000	$44854.4579	1601.038645	15.8
2001	$49128.4328	1644.716076	12.2
2002	$51629.6624	1928.876499	6.9
2003	$55159.1104	2044.995966	9.1
2004	$54633.3387	2035.517432	1.9
2005	$52122.0771	2009.627568	–1.7
Source: AHRQ, Center for Delivery, Organization, and Markets, Healthcare Cost and Utilization Project, Nationwide Inpatient Sample, 1997-2005. ** Adjusted for inflation using the GDP deflator (https://www.bea.gov/data/prices-inflation/gdp-price-deflator, Table 1.1.4. Price Indexes for Gross Domestic Product). **Includes coronary artery disease, heart attacks, congestive heart failure, irregular heart beat, stroke and non-specific chest pain.

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