This is because no one is quite sure what it should cost. Literally. The hospital will try and charge whatever wild number they can get away with, and the insurance company will negotiate it down to whatever they feel they're willing to pay.

My wife is a nurse and has seen this play out multiple times with patients and their families. Just to give you an idea of how disconnected the price is from logical factors, consider this - If the hospital bills the insurance company they might charge $1000 for the scan. If they bill you directly, (always after you've had the procedure of course), you will be charge much much more, say $3000.

Why? Because it's next to impossible for you as an individual impossible to negotiate the price before hand. (How would you know what a fair price is? And are you really go to say no to a procedure that might be critical for your health?)

I have never been inclined to additional government regulation. I think it is bad for society in so many ways. But when it comes to the Medical industry I am not so sure.

I wish there were a law that Hospitals have to be able to quote the price of any procedure within a few hours after the patient asks for it.

People argue that the current system works because capitalism is more efficient. But when the prices are hidden from the customer by either fudging prices or hiding costs behind a fixed fee in the form of insurance the system is broken.

This seems to be one of the fundamental misunderstandings people have about capitalism; they like to think of it as a form of virtuous economic freedom. A market system, however, only works with reasonable information. In this case, it is apparently of benefit to the providers to treat them as trade secrets, but the system will operate more efficiently if they are forced not to do so (as they are in most places).

people forget that efficient markets hypothesis requires perfect information and it seems that hiding information about costs is standard business practice.