Is this normal?

I agree about the hidden extras. My arm lift quote looked simple until I asked whether garments, tests, extra hotel nights, translator, and airport transfer were included. The clinic that answered with a proper breakdown felt more professional, even if the headline price was higher.

Small cautious disagreement: sometimes the doctor deciding final details in person is normal, because they need to examine you. But the clinic should still explain the possible price range and what could change it. I asked them to separate fixed costs from possible extras. That helped me budget flights and hotel without feeling trapped after arrival.