$2700 billing for 24-hour pH test ???

I know medical care charges can be ridiculous, but this one seems over the top. I've been working with a GI specialist on a chronic GERD condition, and went in a couple weeks ago for a 24-hour esophageal pH test. The whole procedure, for those who don't know, consists of spending about 20-30 minutes with a skilled nurse in an outpatient setting (in the hospital endoscopy dept, in my case), getting a bit of lidocaine in your nose and throat, and having a monitor sensor threaded down into your esophagus, with a meter attached to a strap that you carry around for 24 hours. Return the next day, 5 minutes with the nurse to remove the probe, and I assume she spends 5-10 minutes feeding the readout into a computer.

The hospital has billed my insurance $2688, including $2188 for the procedure, about $14 pharmacy (the lidocaine, I guess), and $483 for "Med-sur supplies", no clue what that is unless "rental" of the monitor.

That's more than insurance was billed for a full upper endoscopy I had, that involved a nurse, my GI specialist, an anesthetist, and considerably more time.

So I totally don't get it. If the only answer is "welcome to the US medical care system", I'll understand.

If I want to protest the cost, just on principle, best to do that via my insurance company, hospital billing department, or both? I can afford the projected copay (though not happy about it), but this sort of thing is a disincentive to diagnostic testing that in this case provided pretty significant results.

You need an itemized statement from the hospital. IF, you see charges for items that you are positive you did not receive that will be your only shot at getting any kind of a reduction on the bill. To call & complain about the overall cost will do no good. The insurance only recognizes usual & customary charges for the services in your area. You will only be out of pocket for any co-pays or deductibles.

Drs & hospitals inflate the cost knowing fully well insurance will pay a set amount.