If you go to a mechanic, and get a quote for your auto repair, in most cases that quote is the maximum amount you can be required to pay. To charge more, or to add on services you did not request, would trigger consumer protection laws against deceptive business practices.

If you go to a physician's practice, and get a quote for your human repair, first off, congratulations are in order for getting any number at all prior to service. But unfortunately, that number that you got is pure coprographitto, and it won't be the upper limit on what you pay.

It's much like those e-commerce deals where you can't see the sale price of an item until you add it to your shopping cart. Except in this case, you don't see the price under after you buy the item. And the sale price has a negative discount, meaning you actually paid more for it. You can't meaningfully comparison shop under those conditions.

This is why those high-deductible plus healthcare savings account plans intended to spur comparison shopping cause people to simply forego treatment altogether instead. The only price people can really be sure of is that not going to the doctor at all costs $0 now out of pocket. Going to any doctor can range from "I can actually afford this," to "healthy and bankrupt beats rich and dead, I guess."