This is not strictly an issue of bargaining out pricing contracts. Hospitals are not held to account by consumers to provide transparent pricing, so they don't.

This is not strictly an issue of bargaining out pricing contracts. Hospitals are not held to account by consumers to provide transparent pricing, so they don't. The same hospital that will tell you "we don't know how much this operation will cost; it depends on too many variables" takes a lump-sum payment from Medicare (via DRG) for the same procedure - which ought to tell you they know damn well what, on average, that procedure is going to consist of. If they can tell you what codes it will generally include, that can be translated into cost. They're not even trying to deceive you. The parts of the hospital that deal with you, vs. building around DRGs, are entirely divorced. Your physician literally doesn't know what the procedure will cost you. His office manager literally doesn't know. The billing department doesn't know. And the people who do know? They don't talk to physicians and patients. I've worked /in/ clinical business ops. in an academic medical center and couldn't get my hands on that information (too politically sensitive).