“If InsuranceCo says they'll payback 20% of list price, but it costs the hospital $100 to run the test (including some nominal profit; hospitals aren't non-profits, for better or worse), the hospital must charge $500 for the test, just to break even on InsuranceCo's patients.”

I have never seen a real accounting of these costs so we can see whether they overcompensate. It’s the same with the high drug prices. They always say that other countries underpay and therefore the US has to pay more but you never see any real numbers.