[AnthonyMouse]

The way this should work is that providers have to publish their prices for each service and then insurers publish how much they pay regardless of where you go, which might be something like 90% of the median price, i.e. the equivalent of a 10% copay.

But then the patient can go to whichever provider they want. The one across the street from you charges $3000 more than the one which is a two hour drive away? It's your $3000 and it's your two hours each way.

You might even find a provider that charges less than your insurance pays, and then you could put the balance in your HSA for the next time it isn't.

We keep trying to pretend that some important price negotiation is happening between bureaucracies that has to be preserved, but a CT scan for example is a standard service. If the prices had to be published and put in a database where patients can see them, you don't need anyone to negotiate anything, people would just choose the one with the best price absent some specific reason to do otherwise, which would exert a downward pressure on prices that doesn't currently exist.