Are you telling me that the American healthcare works like an Arabic bazaar, where you start with a price that is 20x the real value and negotiate it down to a fraction of the initial offer?
Difference is, the buyer haggles after receiving the non-returnable service, so they cannot shop around, or use the threat of shopping around as a bargaining tactic. The buyer is entirely captive, while seller may freely decide how low to go (if at all), depending on factors opaque to the buyer.
... And frequently they won't give you a price even if you ask what it costs upfront.