I agree, we should go to menu pricing, that way the 'sands aren't always shifting beneath our feet".  The goal for medical billing is to get the most money possible for any office visit, and individual procedure which depends on their agreement with the insurer.  THAT'S how it becomes complicated.  It is purposeful and evasive to receive a response "Your insurance pays for it"  That is the reply I received 3 times when asking about a particular procedure.  The implication being, you don't pay - so, who cares?  That is the wrong set of rules to be operating by.  WE ALL PAY every single time we do anything in this country.  When will people get that through their heads?