When I had some surgery the list price was $24k, with the negotiated payment of $8k including my $2000 copay, so the the hospital only had a 3x factor for that vs. 20x for the tests. Looking at my lifetime of medical bills, I got far more value from the difference between the MSRP and negotiated rate than I got from the amount the insurance company actually paid. My ideal insurance would be lower payments per month to get the negotiated rate plus payments for catastrophic bills and they wouldn't pay anything most years like car insurance.
100% to everything you said especially about benefitting from the negotiated rate.
Maybe it’s a good analogy maybe not but it’s a bit like paying to join a “buyers club” as opposed to a straightforward indemnity.
The dirty secret is that the “MSRP” can often be whatever the billing entity says it is. In many cases (some cases) it can border on a scam which you escape if you get the negotiated rate.