No, as I already pointed out insurance companies have already negotiated much lower fees with hospital systems. But if you walk in without insurance you're going to see a jacked up rate. If you tell them you can't pay that most hospitals will immediately lower the bill considerably. My stepmother used to go to emergency room a couple of times a year to once every two years or so. They'd hit my father with a huge bill but he'd tell them he didn't have the money. They would immediately lower it down quite a bit. This happened in numerous hospitals in several states. The hospital I went to didn't negotiate, it was automatic for self pay. Took the bill from $33k to about $7000.