American hospitals maintain "chargemaster" prices: fictional rates that bear no relationship to actual costs or insurance-negotiated rates. A procedure that costs $400 to deliver gets negotiated at $800 for insured patients and billed at $3,500 to the uninsured. The 27 million Americans without insurance pay 8.75x actual cost. When you can't pay, your debt gets sold for 1-4 cents per dollar (everyone knows it's uncollectible) and pursued at 24-35% interest. CareCredit charges 26.99% retroactive interest. UCHealth filed 24,843 lawsuits seeking $76.6 million in medical debt.

Then there's facility fees: same doctor, same room, same procedure - hospital reclassifies it as "facility-based" and the price goes up 40-50%. The most-billed code in medicine has a 63.4% error rate. $564 million in improper payments on one code alone.

Markus Grant maps the chargemaster, the upcoding, the trauma activation fees that range from $1,000 to $61,734 (77% of which fail federal compliance requirements), and the $28 billion in nonprofit hospital tax exemptions where 86% of hospitals spend less on charity than they get in tax breaks. Both parties enabled this.

Key receipts:
- $3,500 vs $800 vs $400: chargemaster vs negotiated vs actual cost
- 8.75x: uninsured charge vs actual cost
- 27 million: Americans on chargemaster pricing
- 63.4%: error rate on most-billed medical code (99214)
- 24,843: lawsuits filed by UCHealth for medical debt
- $28B vs $16B: nonprofit hospital tax exemptions vs charity care provided
- 86%: hospitals spending less on charity than tax break value
- 26.99%: CareCredit retroactive interest rate
- 1-4 cents per dollar: secondary market price of medical debt

Receipts and case file: theranter.com/case-file/
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