But it's not shipping in this modern era Alethia because Amazon ships for free if you are a Prime member. Would be a pretty poorly run business that didn't use some form of the Amazon system for bulk ordering. And the cost of living is not that much higher up here than many other states even on the East coast. Just checked through some COL sites and Alaska is just a bit more expensive than Seattle or Portland. U of Washington is a union hospital so the employee costs are just as high as anything Providence or Humana have to deal with up here. The medical industry is price gouging up here. They are counting on Alaskans to believe the decades old myth that it is more expensive to live up here when in fact it is relatively no more expensive than many places down south.