The price you pay depends less on what's being done to you and more on where they're doing it?

Take Medicare, that magnificent monument to bureaucratic logic. They'll cheerfully shell out nearly three times more for an epidural injection if it's administered in a hospital outpatient department rather than a doctor's office. 

Read the whole post here on linked in - by Dutch Rojas

The result of this arrangement is that independent doctors 🥼 let them be absorbed by hospitals as employees, since they will get paid more for the same procedure in the short term. Over a long term this is anti competitive and would be bad for patients and those doctors.

Insurance companies collude with hospitals to do this more and more over years. The exponentially increased price is itemized as facility fee or hospital charge  while the doctor fee part of it stays fixed without adjusting for inflation or may even go down gradually. When doctors ask for a raise to keep up with inflation, the hospitals point out that, what they are bringing in as revenue is actually going down. Technically correct but actually not true. Didn’t they negotiate an exponentially higher facility fee with the insurance on the basis of the doctor doing all the heavy lifting for them. Shouldn’t they have a share of the rise in fees. 

Fresh graduates after residency join hospitals as employees lured in by the sign on bonus and potential of pre established panel of patients. Most of them never even think of considering private practice. 

Note that we are not debating if doctors get paid well compared to other professions. They do. The context here being doctors are doing twice the amount of work, than they did in 2000 to maintain the same salary and standard of living. And this calculation hasn’t factored in inflation. If you adjust for that their salaries are seeing a steady but sure decline over this period.