[jandrewrogers]

It is a game. Insurance companies and government insists on paying pennies on the dollar of the cost, so the medical care profession pretends like it charges some large multiple of the cost so that the "pennies on the dollar" is much closer to the true cost. The government and big insurance companies have contracts stating they only pay the lowest published price, so you can't give anyone else a more sensible price. There are all kinds of perverse incentives.

In this particular case, most of the bill is for the anti-venom treatment course. Anti-venom serums are pretty expensive to produce, and if you do not know the exact species of animal the venom came from (which often happens if the creature was not killed), they give you an anti-venom cocktail serum that covers all the common venoms in the region. It generally requires a couple days in the hospital too because the damage to the body from the venom can be extensive even though you survive, it depends on how lucky you are.

Proper treatment of pit viper envenomation is going to be relatively expensive in any country. It isn't like treating a broken bone.