Providers may be under increased reimbursement restraints, but consumers might have a hard time believing it. The median charge for a private room in a skilled care facility exceeds $90,000 a year, a new survey finds.

In fact, the “Cost of Care” report from Genworth Financial puts the annual charge at $91,250. For many families, that can be as much as three years of private-college tuition. The annual increase has topped 4% or more for the past half decade.

“Most people don’t realize how expensive this care can be until a parent or family member needs it,” said Joe Caldwell, director of long-term services at the National Council on Aging. “And then it’s a real shock.”

Genworth sells private insurance policies. Its latest report again found wide discrepancies across states. In Oklahoma, the median skilled care cost was $60,225. In Connecticut, it hit $158,775. Alaska was even higher: $281,415.

The survey placed the median annual cost for care in an assisted living community at $43,200. It priced home health aide visits for a year at $45,760.