This is a GREAT question! It will continue to be a "thorn" as more and more consumers move into HSA
or consumer-driven plans.
Here is a primer.
In most every metropolitan area, and even if most non-urban areas, the doctors contract with carriers under the umbrella of what is known as a PHO or Physician Hospital Organization. Here is an example: In a metro area, one major hosptial system may have 1,500 doctors affiliated... their managed care professional will do all the negotiation with the carrier and arrive at a discounted figure that they BELEIVE all the physicians will agree to take. Once agreed upon, they send out inidivudal opt-in forms to each doctor who then INDIVIDUALLY decides.
MOST PHO's have very strict rules and agreement that Doc's will not go-around the PHO and contract directly, but it does happen and more so in the rural areas. Rarely do carriers have the man-power or money to contract individually with each doctor.
Beleive me, Doc's and Hospitals DO NOT want you to know what they have agreed upon, because one carrier will use it against them in negotiation... for example, BCBS might get a 70% discount but Humana only gets a 40%.
Doctors and already seeing an increase in patients calling asking what it costs for services.... which of course, most don't know the answer too.
Hosptials are seeing this also......
It's a part of the growing pangs what we will all have to live with as we move to consumerism.
: Aetna is the ONLY carrier with TRUE transparency in the market. They list the actual price on their site for members.... not the "typical" or "average" or "CMS" pricing. This is an interesting point for HSA