Sentence:  That 's why the FDA , the American Medical Association ( AMA ) , and the National Better Business Bureau ( BBB ) have estimated the <WSD>toll</WSD> of mechanical quackery to be a substantial portion of the $ 610 million or so paid to medical charlatans annually . 
Meaning of the word marked with <WSD> tags:  a fee levied for the use of roads or bridges (used for maintenance)