Not only that, but insurance companies get to negotiate special rates, but as an individual you have zero opportunity to do so, zero leverage. That is, to your point, the price of the service is 100% flexible. The ambiguity and confusion benefits those who are best positioned to benefit from it, that's not the individual.

It's a system optimized to be self-serving. It's the Healthcare Industrial Complex, that doesn't actually care much about health. Profits over people.