One of the inequities of our private insurance system is that people without insurance are typically charged much more for procedures than those who have insurance. I carry a large deductable, so my insurance premium is merely insanely expensive, rather than impossibly expensive. When I go to the doctor, she sends a bill to the insurer, who approves a fraction of it. The doctor then sends me the reduced bill and I pay it. If I had no insurance, I would get the larger bill.