english: Their fees were set years ago, sometimes at the practice inception, and they may raise some once a year, every four years and many not at all.
non_english: うぐぅうぐぅうぐぅうぐぅうぐぅうぐぅうぐぅうぐぅうぐぅうぐぅうぐぅうぐぅうぐぅうぐぅうぐぅ うぐぅうぐぅうぐぅうぐぅうぐぅうぐぅうぐぅうぐぅうぐぅうぐぅうぐぅうぐぅうぐぅうぐぅうぐぅうぐぅうぐぅうぐぅうぐぅうぐぅうぐぅうぐぅうぐぅうぐぅうぐぅうぐぅうぐぅうぐぅうぐぅうぐぅ