One important piece of context here is that these rates are negotiated as part of a contract bundle where an insurer is bringing a pool of patients to the facil

One important piece of context here is that these rates are negotiated as part of a contract bundle where an insurer is bringing a pool of patients to the facility. Prices can vary widely procedure to procedure because they are associated with over or under representation of certain factors within that pool. For example, grossly simplified, I might have a particular service line, hip replacements (an ortho program). The insurer whose patient population is going to 'keep the lights on' in that service line is going to see a very different rate per service than a different insurer who rarely has patients that need it. Nothing about these prices shown are really reflective of the costs of doing the procedure such as pricing in a retail store. I do think this transparency initiative will result in more consistent costs but not necessarily net lower costs. Comparisons to other countries that are smaller than the united states are somewhat apples to oranges. There are a lot of factors that are glossed over when someone says "costs are 5x higher in the US than my country" including real estate, energy subsidy, and so on. Its a deep well.