It’s a total racket. The worst part is that they’ve managed to tilt the playing field in their favor for even routine fees. Cash prices are higher than “pre-negotiated” reimbursements, unless you cry poverty and a billing clerk cuts you a discount after examining your tax return and assets as an alternative to collections. So you have to buy insurance which is an act that reinforces the hidden inflated prices model.

Average people only have one rational response to random prices: don’t go to the doctor voluntarily. But this can cost them their health in some cases.