we were billed $20,000 for the use of a doctors exam room (not in a hospital, just an office building) for a routine outpatient procedure. It took about 40 minutes, and involved an ultrasound machine and another piece of equipment, rolled in on carts for the moment. This in addition to the doctor and supplies. It was supposed to be a clinical setting, but the bill arrived from a hospital. Turns out the "clinic" is a well hidden wholly owned subsidiary of the hospital, which allows them to dupe the insurance company into thinking it needs to pay hospital ER rates.