That’s interesting. The friends I talked to did mention this, but it sounded more like you could knock the bill down a bit, perhaps in the 10-25% range (10% being a lot more likely). The er physician I spoke with seemed skeptical That you could negotiate it down anything like and hmo with massive negotiating power could, but that is just one conversation, and ER docs may actually not be the most knowledgeable people about this. A hospital admin or financial person would probably be a better source.