Hospitals seem to have an infinite number of prices for the same service. The most expensive of which is that charged those least able to pay, i.e. the uninsured individual. In this case the pricing for the medication (rabies immune globulin) was several multiples of the actual cost. This was added on to ER fees which I presume included the physicians fee and the facility fee. The insurer, in this case did not have a contract with the facility and was charged significantly more than other insurers but much less than the price quoted originally.
But that of course is the nature of health care in the U.S. The system is not designed to provide value or even excellent healthcare, but rather to maximize revenue. In private for-profit companies (as well as most “non-profits” ) the fiduciary responsibility of the company’s management is to maximize revenue and provide profit for stockholders or sponsoring organizations. As a result we have the most expensive health care in the world with the highest cost/capita, the most bankruptcies from health care costs, and the most uninsured citizens (in an industrialized country).