Yea, it’s called capitalism. The old supply and demand thing.
If the demand is artificially stimulated by free medical care, or if the supply is artificially limited by regulation or collusion, the Law of Supply and Demand gets a bit warped in the process.
The co-pay of $250-300 is in many cases, the realistic value of the service! The physician-owned MRI units charge the insco $4500, or whatever they can get away with. In their defence, such as it is, when the Gonzalez brothers ... all 18 of them...get their MRIs for "free," the MRI company graciously waives the co-pay and probably only bills the funding agency a low, low $2800 each!
I claim that the medical accounting theory is all screwed up ... like oil depletion allowances... entertainment business practices ... municipal road contracts, etc. The main thing screwing it up is that millions receive medical services for free, while thousands pay for insurance and make co-payments. That's hardly "capitalism" in action.