Why Costs are kept Secret !

For the Hospital:
For-Profit Hospitals will almost never attempt to quote you a cost for a given procedure -- for instance gallbladder removal. The reason is that most for-profit hospitals work on a Cost-Plus billing scheme that allows them to apply a usually marked up fee for every item allotted to the patient and then add a margin for profit and to help cover other unpaid bills. In addition, the hospital doesn't know ahead what your treatment will require. They may be willing to quote you an average cost for uncomplicated gallbladder removal but many hospitals will simply say they don't know what you will require. The really good well run hospitals will quote you a fixed price and stick to it. A few years ago a large airline negotiated the cost for heart by-pass operations with several large medical centers. These hospitals set fixed prices for heart by-pass operations and stuck to them. Most for-profit hospitals will not even consider this. The hospital medical staff really has to know what they are doing to be confident that they can carry out treatment without a mishap. For-profit hospital administrators like to see well insured patients have a complication or become seriously ill; the hospital makes more money that way.

For the Doctor:
The doctor knows full well what his charges are but he is reluctant to tell you. If you ask the cost he may say he doesn't know right off the top of his head and that his accountant or billing clerk set the prices; but don't be deceived, the doctor has full control over charges. In addition, the doctor may simply not want to explain why he is charging $10,000 for a 15 minute arthroscopy or a 1 hour gallbladder removal. When you get the bill and call to ask about it you are directed to a billing clerk who has had a lot of practice explaining charges and can give you a thousand reasons for the charge -- or she may be gone for two weeks and you will have to call back.
The simple answer is that this doctor is greedy and in the business to get rich, not to provide the best possible care in the interest of the patient. The two objectives are incompatible and mutually exclusive.

The bottom line is that it is best to ask the cost ahead of time. If you don't get an answer or the price is too high, go somewhere else. Try to find a large well-run non-profit clinic where the doctors are salaried and not paid a fee per case.