Its a U.S. medical bill.

The hospital asks for whatever the fuck it wants after it does the treatment.

Then insurance says "we only pay a negotiate rate" and pays $25-$30K."

I had intern from France a year back when I worked in research. He went skiing and broke his leg around 6 months in. The French healthcare system sent him a check for how much the medical treatment would cost in France. It was around 10% of the bill. He paid the 10% to the hospital.

The hospital kept billing him and sent some of the bills to collections. He asked me what to do about it. "Tell them they have been fully paid by the French health system and to take it up with them. Then go back to France in 2 months and forget about it."

He laugh and said they immediately stopped bothering him after that.