I had a friend who had an appendix removed, the bill was $80K, similar to what you quoted. He didn't have insurance, however, so he haggled on the bill. Eventually they settled and accepted $8K, or 10% of the sticker price, for the procedure. I don't know how insurance companies settle these things behind the scenes, but I imagine many are overpaying and we're all paying the cost through higher insurance prices.
Insurance companies have zero incentive for real procedure prices to ever be listed; they provide 'value' both in terms of their negotiation services and in terms of pointing to how expensive getting anything done is.
However the true result is presented to wall street: If the insurance company is making more than a very meager profit we're getting screwed out of what should be universal affordable care.
