There are fee guidelines. The govt sets caps for the folks who get medicare / public aid. Insurance companies negotiate rates for everyone else. So much so tha

There are fee guidelines. The govt sets caps for the folks who get medicare / public aid. Insurance companies negotiate rates for everyone else. So much so that when my wife was going to get an Iron infusion the doctor couldnt let us pay for it out of pocket ( we were in a hurry to go somewhere and couldnt wait for insurance) we were told we couldnt pay out of pocket unless the insurance company allowed it Let that sink in... you cant pay for healthcare out of pocket unless your insurance allows it.