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Physicians Are Increasingly Up-Charging for Routine Care

By NAM NewsroomNovember 5, 2026

As hospitals purchase more doctors’ offices, routine patient visits have become more likely to be billed as pricy hospital care, driving up healthcare costs (The Washington Post, subscription).

What’s going on: “The higher rates along with hospital ‘facility fees’—tacked on even when patients never step into a hospital—can lead to bills 10 times costlier or more,” according to research on patients’ bills.

  • Hospitals would bill $500 billion less over the next 10 years if federal law prohibited them from charging higher rates than independent physicians’ offices for the same services, the Blue Cross Blue Shield Association estimates.
  • Hospitals justify the higher bills by saying the charges help pay for the complex, 24/7 care they provide.

A long track record: This pricing practice has been on the rise for years, according to the Post, and the additional costs can be extreme. 

  • Nerve block injections performed in doctors’ offices cost an average of $282, compared with $1,530 when billed at hospital rates, according to the Health Care Cost Institute.
  • Radiation treatments cost an average of $218 in a doctor’s office and over $1,000 when billed as outpatient hospital care.
  • One patient, who was billed more than $600 for a routine cardiology visit with a hospital-affiliated physician, switched to a provider who wasn’t employed by a hospital—and saw his out-of-pocket costs plummet.

Why it’s happening: Nearly half of all physicians in the U.S. now work for hospital systems, according to the Government Accountability Office. As the consolidation of the health care sector continues, outpatient costs keep rising.

  • Meanwhile, insurance companies find it difficult to identify when hospital rates are charged for procedures performed in doctors’ offices, which helps hospitals game the system. 

What’s being done: Insurers and lawmakers are exploring ways to curb the practice of charging hospital rates for routine care or adding hospital facility fees for services provided outside hospitals.