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> The doctor's practice or hospital gets the extra $1656, from the insurer.

No, they don't.

Insurance pays out their negotiated rate of like $100 for that 15 minute appointment. (Which likely has some pre- and post-appointment work involved. My doc has clearly at least skimmed my chart prior, and I get a written note later. I'm also seen by a nurse initially.)

The rates have to be obscenely high on paper so the insurer gets their big win negotiating.

The rest just... evaporates. https://imgur.com/a/X5oLXgr




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