My late brother-in-law (not the Pharma CEO) was a business major who went down the line item bill of his daughter's birth, which was well over $20,000 in 1991. He called them out on several charges that were either unnecessary or never delivered, and they reimbursed them. Most people don't do that, maybe because most insurance companies are paying for it. Why insurance companies don't contest hospital charges or demand economy of scale pricing is the real issue.
Semi-related: I caught an auto shop double billing on a car repair and notified my insurance company. They thanked me for my thoughtful diligence, but admitted they would just pay the bill and not follow up because it was too much trouble.