> However, I cannot "enter the negotiation" even with a cash-paying-patient legally without charging the top-line price. Yes, this is true and if you try and s

> However, I cannot "enter the negotiation" even with a cash-paying-patient legally without charging the top-line price. Yes, this is true and if you try and settle with a cash-paying-patient who's insured, the insurance company can drop you as well as pursue breach of contract damages. > By law, we can only charge one price to all payors What law is it? because this is absolutely untrue in a country that does not follow an all payer rate set system and the U.S. ain't one. In the U.S. the VA pays one rate, Medicare another, private another, Indian Health Service (IHS) and Tribal Health another and so on. Here's a helpful chart for you that shows all the different parties each of who pays different rates for the SAME CPT CODE: https://qph.fs.quoracdn.net/main-qimg-72f33aa55c71c439fc4660b23333c55b-c https://qph.fs.quoracdn.net/main-qimg-72f33aa55c71c439fc4660... Infact a lot of avarice ridden providers refuse to treat Medicare patients, who need the most help, precisely because Medicare pays less than private party care. > one of literally 200 radiologists in my current practice, I have no say in those rates at all Oh yes you do. Most radiologists dont even attach themselves to a network because they can bill OON. Which is why 35 percent of adults have surprise bills for imaging services: https://www.radiologybusiness.com/topics/healthcare-economics/surprise-billing-imaging-services-survey https://www.radiologybusiness.com/topics/healthcare-economic... Let me quote another article: http://www.ncsl.org/research/health/counteracting-surprise-medical-billing.aspx http://www.ncsl.org/research/health/counteracting-surprise-m... > As an example, a woman seeks care for a broken limb. She is careful to go to a hospital that is in her health insurance plan’s network. She remits her copayment and receives an X-ray. Several days or weeks after the visit, the woman receives a bill for hundreds, possibly thousands, of dollars. Even though the patient was seen at an in-network hospital, the radiologist who read her X-ray was not in her insurance network. Still, the patient is responsible for picking up the out-of-network cost. No one is forcing a radiologist to be OON - it's their own decision and they do it exactly to have a say in their rates. It's fine to want to make money. Whats the big deal with all this smoke and mirrors? Here's how a business transaction outside healthcare in the U.S. goes: Party A: Hey B, you have X, which I need Party B: Yes. I have X, and I want $Y from you Party A: OK, but can you try and do it for a bit less, say $Z? Party B: Yes. Here's how a business transaction in healthcare in the U.S. goes: Party A: Hey doctor, you have X, which I need Doctor: Yes. I have X, and I accept your insurance! Party A: OK, here I am. $30 co pay, right? Doctor: Yup! Doctor (3 months later): Oh, turns out you owe me $250 for the local anesthetic and $1700 for use of the camera I shoved down your throat 3 months ago. Also the thing I did was surgery because I went inside your body so it's not a $300 in office visit but a $750 one. If you don't know what endoscopy is, it's your fault you ignorant slob. It's your fault you didn't know all of this. I didn't go to medical school for nothing, now pay up or I will repo your house and garnish your wages. The pain is showing now. People are really upset about how they have been and continue to be taken advantage of