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Costs in healthcare aren't very "real". US providers use what they call a charge master to determine prices. So while an "IV" may show up on the bill, it's not the actual IV you're purchasing when you're in the hospital. Behind that number the hospital has factored in all sorts of cost centers such as part of the nursing staff cost for example. These "costs" therefore do not represent the true actual cost of providing the service, but rather the charge that the insurance company will pay. Insurance companies have a negotiated rate that they will then pay to the hospital. One of the major "hidden" problems in our current healthcare market is that there exists extreme consumer price insensitivity (since most cases are covered by some type of insurance) alongside large consolidation of healthcare providers.