"I explained that just because he had health insurance didn’t mean he had to use it in every situation. After all, when people have a minor fender-bender, they often settle it privately rather than file an insurance claim. Because of the nature of this man’s policy, he could do the same thing for his medical procedure. However, had I been bound by a preferred-provider contract or by Medicare, I wouldn’t have been able to enlighten him."
My wife and I have run into multiple cases in the last two years where our providers would have offered substantial discounts for paying cash, however because of the provider's contractual obligation (and state law, to boot) they are unable to accept cash payment and are required to bill our insurance at a higher rate than their cash discount. Since I have a high deductible I end up paying for the procedure out-of-pocket at a higher rate than if I could have just paid cash. It's maddening.