[brewdad]

If insurance doesn't approve the test, it won't be paid for. Insurance also means US prices for tests are elevated to 10x what they "should" cost because providers expect insurance to knock the price back down to a reasonable cost. As a result, ordering a bunch of unapproved tests leads to huge out of pocket costs for patients so only the wealthiest will ever be willing to push for them.

Ironically, that same population also is the most likely to have insurance that will cover the tests in the first place. So it goes.

[smabie]

You actually can negotiate pretty easily with most hospitals / doctors. After getting the bill just say you can't pay and offer a fraction of the cost. Many times they will say yes (alternative for them is selling the debt for cents on the dollar anyways)

Source: have done this 2-3 times in the past when I was poor / used to not have self insurance.