Is it legal for a health insurance company to charge more for a procedure than what the actual charge from the hospital is?

Is it legal for a health insurance company to charge more for a procedure than what the actual charge from the hospital is?

I recently had a procedure done. The actual cost from the hospital is around $2300 but the rate agreed upon between the hospital and insurance company is around $4800. Therefore the insurance company has paid the hospital around $2200 and I’m still responsible for the remaining amount. This doesn’t seem right.

Asked on July 25, 2012 under Insurance Law, New York

Answers:

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