For a given customer, the "gallon of milk" costs the same regardless of which shelf it comes from. But if you come in to buy milk and end up buying champagne instead the price will be different.
Billing amounts are calculated based on specific unique procedure and modifier codes. The coding is typically done by trained coders using the doctor's notes as a reference, and the coders select the most expensive codes that they can legally justify. Many doctors aren't even aware of their billing rates for various procedures. In some cases the doctor won't know which specific procedures will be needed until she gets into it and sees what's going on, at which point it's too late for price estimates.
Payers (insurers) are trying to fix the billing system by moving away from the fee-for-service model and toward value-based care (payment for meeting care quality goals) or various forms of capitation (flat payment per patient per year regardless of which procedures are needed).
Billing amounts are calculated based on specific unique procedure and modifier codes. The coding is typically done by trained coders using the doctor's notes as a reference, and the coders select the most expensive codes that they can legally justify. Many doctors aren't even aware of their billing rates for various procedures. In some cases the doctor won't know which specific procedures will be needed until she gets into it and sees what's going on, at which point it's too late for price estimates.
Payers (insurers) are trying to fix the billing system by moving away from the fee-for-service model and toward value-based care (payment for meeting care quality goals) or various forms of capitation (flat payment per patient per year regardless of which procedures are needed).