If all they did was give you sedation, that charge is way out of line.

Now, here's how it works.

Medicare and Medicaid allow doctors to charge no more than what is charged to them, regardless of what they actually pay. In Washington State, for instance, Medicare typically pays only about 45% of the billed charge, Medicaid (the state version of insurance) pays about 20-25%.

However, because the law says you can't charge less than you charge them to anyone else, people who pay out of their pocket must pay the entire bill.

The insurance companies get charged the whole amount, but they only pay a percentage also, that percentage is supposedly negotiated, buy in reality, they tell the doctors what they will pay and it is a "take it or leave it" proposition.

So, lets say you have 5 people who are going to have a procedure done. The total cost(not what the doctor makes, but the COST) for all the procedures is $5,000. The doctor needs to make $500 for each procedure to make any money. So the cost plus profit is $7500.00 or $1500 per procedure.

2 of the people are Medicare:

Medicare pays 50% of the $3000, or $1500 total

1 is Medicaid:

Medicaid pays 25% or $375 total

1 is insurance, which pays 80%. (They don't usually pay that much, but I'll be generous.)

Insurance pays $1200.

The total paid by those 4 "insurance" programs is:

$1500 + $375 + $1200, or $3075. But guess what, the cost alone was $5000, the doctors profit was $2500 on the procedures, so the cost of the procedures wasn't met, much less the profit.

Guess who gets the bill for the rest!!

The last guy, the one who has no insurance. Since there is no profit, and so far the costs haven't even been met, the doctor then charges the last guy $4000 to try to make it up!

Now this is a vastly oversimplified version, but you get the idea. The insured people and the government have all the cards, the rest, none.

Fair, NO. But that's the way the game is played.

Bill