I'm not really sure this means anything frankly. Has you ever looked at the "rack rate" of the hotel rooms you stay in? Anyone ever pay that rate, or anywhere close to it?

The potential impact is on those without insurance, as the hospital could basically stick them with the "rack rate", but even then if the person doesn't have the money, they don't have the money. And the affordable care act hopefully increases the number of folks with coverage.

Note that insurance rates are negotiated from the chargemaster rates. So this does impact everyone. It remains to be seen whether releasing the rates will make a difference.

Thing is, this isn't news to insurance companies. Most work off a very, very large database - far larger than this study - and they know what a procedures average cost in a given area is right down to the penny.

They will pay a % higher or lower depending on the bill, but they are simply going to refuse to pay anything more and they can't be sued because the legal standard for what they have to pay is called "usual, reasonable and customary" based on that database.

Here's the trouble (and I'm in the middle of this now, more or less).

Dr. X charges me $20,000 for my stiches. The insurance company looks in its database and decides that $2000 is usual, reasonable and customary for my zip code of 11215. My insurance plan says they are responsible for 80% so they pay $1600 -- 80% of usual, reasonable and customary.

But I don't get a bill for $400, I get a bill for $18,400. Here's the tricky part - the doctor cannot, legally, forgive my protion of the bill. Why? Because the insurance company will sue him for fraud -- after all, if he forgives the bill then the procedure in question actually wasn't worth but he charged. And if it wasn't worth what he charged, they want $1600 back.

So insurance companies - in an effort to make sure that customers have some financial stake in medicine - use litigation (and now, in some places, legislation) to require doctors to balance bill the patient.

In network doctors have an agreed upon rate and that keeps these problems from happening. Out of network doctors don't and they are able to bill what they want.

Of course this is just another argument for Mediare for all - then everyone is in network.