My experience is that most medical providers offer significant discounts for patients who pay directly.
They have to, because the list prices are outrageous and bankrupting to many. Better a quarter of a loaf than no loaf at all, so to speak. But, forcing someone to go through this when they are seriously ill is F'd up; and forcing everyone else to haggle or be extorted is also wrong. The Pricing Club component is still there in the insurance scheme, even if it isn't always strictly adhered to.