The hospital and the doctors. Almost $500 for a tetanus shot is simply not justifiable
In private practice outside a hospital, they perhaps have more guilt here, but in an ER? They set the prices about as much as the janitors do.
The law here has changed since then to prohibit this kind of thing, though.
The doctors likely have very little say in the pricing.
Most medical practices employee (or outsource) medical "coders" whose job it is to take the notes written by the doctor and determine which procedure codes should be applied (which then determine what gets billed for)
Which hey, I'm glad they are there, but it also isn't "nothing to do with" it.