You are over simplifying the problem. First off, the place you quote at 2K is probably an imaging business or part of a larger business that can keep the machines more fully utilized. The hospital has it's equipment to support it's main business. Nobody is going to the hospital for routine imaging. Next, nobody pays $10K at the hospital. Insurance will either have an already agreed to rate or will negotiate it down. As a private pay patient, you can negotiate it down. For planned imaging, a lot of people still won't shop around. Even with a deductible, it should still be the negotiated price. After deductible they all cost the same for most people on insurance. Modern Healthcare isn't a free market. These days insurance has most of the power.