"After decades of being dominated by third-party payers, hospital charges are meaningless. On average, hospitals charge Medicare 3.77 times more than what Medicare pays, with a range of 0.42 times to 16.23 times. In other words, if a hospital sends a claim to Medicare for $10,000, the hospital is most likely to be paid $2,653, but they payment could be as little as $616 or as much as $23,810. This has evolved over the years as a kind of symbiosis: It allows insurers to assert they are negotiating impressive discounts from hospitals; and allows hospitals to complain they are being pinned to the mat by insurers."

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