A similar situation in local political health care plans. I did medical billing. Our local govt agency (this was for medicaid level care) required that they only pay 25% of the price of the service. When 90% of your patients are on medicaid, you raise the price so that 25% of price is now what price should be.

But very funny when someone comes in and wants to pay cash. While that would be SO much easier than dealing with the agency - you got to charge them 4x so some politician and HN posters can go on about how much money the govt "saves".

I just wish prices (cash paid) had to be posted publicly.