The current market leaders could run into some challengers.
A California teacher has asked the state attorney general to investigate a $87,500 bill for minor knee surgery even though her insurance company is willing to pay.
Lynne Neilsen told the Los Angeles Times that Blue Shield of California sent her a check for $84,800 and told her to sign it over to Advanced Surgical Partners. The newspaper said the procedure she had normally costs about $3,000.
"This is insane," Neilsen said.
Neither the Long Beach Unified School District or its employer had any apparent qualms about the bill.
"This bill is so outrageous it almost takes my breath away," said Gerald Kominski, who heads the UCLA Center for Health Policy Research. "This is an example of what's wrong with our healthcare system, and employees and taxpayers of the school district are paying the price here."
This week, after calls from the Times, Blue Shield and Advanced Surgical Partners agreed to bill a smaller amount, the newspaper said. But Kominski and other experts say surgery centers try to attract patients with good insurance and then bill their insurers for large amounts.