My experience has been that if you don't have insurance, the hospital will cut a big chunk out of your bill immediately. Their "negotiated rates" are all just made up things they put on the insurance bill because insurers can pay a lot of money. The insurer calls and says "Hello, I would like a discount". And the guy says "Ah, yes, our standard rate is cash rate + $1000, but for you, I'll take off $500".

For instance, a podiatrist I know charges $350 to the insurance company (which shows this as the discounted, negotiated rate) but $150 cash to remove an ingrown toenail.

I'm sure there are exceptions.