chimeracoder seems to be saying that this is because of the complexity that comes from interacting with insurance companies and the public payers. Where I don't really buy that explanation is where there is in fact a fixed capital cost associated with the machine, and a certain number of uses of the machine per year, and a pretty fixed level of complexity per use (different scans will take a different amount of time, but each type of scan will be reasonably consistent from patient to patient). So they can take a spreadsheet and put in the capital costs and the operating costs and the staffing costs and boom, they have a ballpark figure for what each scan costs. It won't be the exact number for a given scan, but it will be closer than not having any estimate at all. I don't see where complexity on the billing side prevents them from doing what I describe.