The insurance company pays, but what they pay is not this price. US medical care is littered with dummy sticker prices that exist to give insurance company negotiators something to do besides negotiate good rates. https://www.propublica.org/article/why-your-health-insurer-d...

Not exactly. Insurance typically negotiates paying a small fraction of the price that cash customers pay.

Medicare has long had a law effectively saying "you must offer Medicare the cheapest price you offer anyone". I wonder how much of an impact it would have on the affordability of care if there were a law saying "you must offer cash customers the cheapest price you offer anyone"?

Not that straightforward for many. My employer pays for 80% of my insurance premiums, and then the insurer (or my employer) gives me a $200 credit (equivalent to paying me) for going to an annual wellness visit.

Of course, in totality, everyone’s total premiums are paying for the visits, but on an individual basis, those getting the visit and receiving a credit are getting subsidized by those not receiving a credit.

You don’t pay this amount. Healthcare has a tendency to show a high price, then charge a much lower price to insurers. So no one is really paying this price.

So it’s like a Persian rug store where every rug has a $9000 price tag and then every customer pays $3000.