Actually MD's must accept what Medicare pays and not bill the patient the rest...that is the deal. That being said, the MD's bill insurance a very large sum. My surgeon billed BC/BS over 15,000 dollars. Blue Cross paid them $1700. and because they in in network that is all they got. Talk to the practice and ask what they routinely get paid by other private insurance. Agree to pay the difference. They can bill you for things that Medicare does not pay for, support groups, preop and post op classes and the like to make up that difference. Someone must have a creative brain in that practice.