Insurers negotiate with each group of doctors. Some (BCBS Select Health) pay more than others (Medicaid/Medicare). In order to have one "price" we take our highest payer and add 10 or 20% so as not to lose any money if they increase their reimbursed amount.
By law we cannot charge someone without insurance less than we do those with insurance. To get around that most doctors will undercode someone without insurance or offer a discount if you pay cash.
The downside now is that most people are on high deductible plans now and so a lot of people are essentially self pay even though they have insurance. Those people get dinged. They get charged the jacked up prices but their insurance is not actually paying anything so they are stuck with this inflated bill. They also don't get the sympathy that someone without insurance would, causing me to under bill.
I realize this issue is ridiculous but as a provider I don't know how to fix it. Without getting rid of insurance altogether, or at least in primary care.