So insurance companies are setting prices arbitrarily. Who has the leverage in this situation?
Insurance companies have the pricing leverage in most situations, partly because in many areas, there is a de facto monopoly. Small doctors offices and even small groups do not have leverage to negotiate prices, so insurance companies dictate fee schedules. Sure you can not accept their insurance, but if there's little competition in the insurance market, that is a death sentence. So the solution is for all the doctors to form a big group with hospitals and drop abusive insurers.
What does this mean? No more small doctors offices. We'll just have large corporate medical systems and large corporate insurers fighting it out. That's the wave of the future and a waste of a lot of money.