The entire pricing scheme is an elaborate sham if you ask me. My wife had to have surgery. A outpatient laparoscopic procedure that required cutting a tendon. The time she spent at the facility (from the when they took her back and discharged her) was about 3 hours. A month later we got a statement showing they tried to charge $67k and were denied… followed by a separate bill for $7.5k We ignored the bill and contacted Anthem who said the hospital didn’t code it correctly. Anthem said they would resolve it. A month later… another attempt to charge $67k another separate bill for $7.5k. Again we repeated the same process. This time it appears it went through. Final total when they “coded it correctly” was $74k.

I have a friend who had to have an emergency appendectomy this year. She paid $1500 for it after insurance. My father had knee surgery he says they tried to charge the insurance company $64k for it.

At this point I think the pricing is all arbitrary. It’s about them trying to charge what they think they can get away with and sticking you for the rest. Kind of like raising the price so you can offer a deep discount later on. I think the real price of the surgery (without insurance) was probably the $7.5k.

I can think of no other business where you agree to have work done without an agreed upon price. The insurance company will tell you it’s covered but the hospital you go to may decide to play games with you. At the very least I suppose they are just hopping you pay so they can collect interest on your money on it before sending it back.