I ask, every time. They will do just about anything to not tell you, or to tell you only the insurance rate. You're screwed if you go to the ER. I had to get an EKG done - they managed to charge my insurance over $1000, something that in almost any other country would be around $50, and even some hospitals in the US.

I think the hugest problem in the US thats not been looked at is regulating the providers - I don't think competition alone will help in emergency situations, but at least with doctors visits knowing how much something would cost would be incredibly helpful.