It's a negotiation. The $200k is simply the starting/maximum ask by the hospital to the insurance company. A bunch of automated and (sometimes) manual systems g

It's a negotiation. The $200k is simply the starting/maximum ask by the hospital to the insurance company. A bunch of automated and (sometimes) manual systems go back and forth until a price is agreed upon. Eventually everyone agrees on paying $50k. Like any negotiation you want to start high rather than low.