[riahi]

That's the big problem. What we charge is universal across carriers; it's the law. What the carriers then do is try and negotiate me down to accept some fraction. I could charge $5,000 to everyone for a PETCT; Medicare laughs and will pay a set amount. Depending on their market power, private insurance will pay a multiple of what Medicare reimburses. I would be stupid to set my "charge" lower than the maximum a given insurance will possibly pay.

If I charge under what they will pay, they aren't going to reward me with all that savings.

If someone wants to negotiate with me directly, I'll charge you some other price, then write off the rest, just as if you are phkahler insurance co. It's the only "legal" way to offer a discount.

[phkahler]

What I want is not possible without legislation. I want you to charge your rate and the insurance companies not be able to negotiate other than walking away. The only way the insurance company can save money then is to not cover the full amount and pass the rest on to the patient. Now you have to compete with others like you, and insurance companies have to compete with others like them. The super-awesome doctors can charge whatever they like and only take cash because insurance companies won't cover their services, and that's fine too - I know of a couple guys like that already and they are awesome at what they do.