Quote:
Originally Posted by Pavka007
Who is determining the RETAIL price??? Can you find a guidance book for medical prices?  |
It's determined by the person writing the bill.
The $295 charge is what someone without insurance would pay.
If the actual cost for the procedure + a decent profit for this procedure is in actuality around $100, then the retail or uninsured price will be jacked to reflect the negotiated rate. IOW, the insurance company makes a deal with the hospital to pay 50% of the billed rate. The hospital doubles the bill. But some insurance companies have a deal to pay 60%. Think the hospital will still double the bill? Of course. Some insurance companies will pay less than 50%, and make their customer pay more of the bill. Think the hospital will still bill the double? Of course.