Total scam.
Trump was right, as he often is, that medical billing prices should be published by the provider. Let the customer choose. Right now the whole thing is so opaque, with different insurers getting different discounts and pharmacy suppliers giving rebates etc etc.
And you thought figuring out the dealer price for a new car was difficult!
If you look at the elective surgical industry - nose jobs, tooth implants, breast augmentation and the like - they are very transparent about their pricing because they have to compete in a free market and there is no insurance for those procedures. The price they quote is the price you pay and you can shop around for price and quality and other factors. The entire medical establishment should do the same.
The problem is that hospitals can’t really post medical prices for emergency room visits because they don’t know what treatments you need in advance. Posting prices is ideal for elective procedures where you schedule them in advance and have time to consider alternatives, get a second opinion, etc.