You still have a choice between competing hospitals / doctors in a system where prices are not inflated for insurances' catalogues.
Only the surgeon's pricing was available ahead of time. The hospital provided an invoice at the time of surgery, marked as "SUBJECT TO CHANGE". The anesthesiologist himself didn't know how much his services would cost.
Three weeks later, we're still watching invoices and insurance claims roll in.
Medical tourism is a direct testament to inflated charges as a systematic problem. Finding a hospital with non-inflated costs requires crossing international borders.