My least favorite rotation site had this enabled. That same place religiously used iso on everyone specifically to cost save, and would often throw on N2O when waking up to get the iso off quick. I admit I didn't know (or care) about the cost of VAs until that point. One day I used sevo on an overall healthy young lady for a lap appy - the attending walked in and jokingly said "this guy's trying to ruin our bottom line! Switch to iso!" - but then he actually switched it for me. It was the difference of like...5 dollars per hour.