Precisely. Yet it is completely normal in American medicine. And worse, the actual patients are rarely aware of the total amount billed or paid because their insurance company handles it.

If they didn't itemize, you would complain that all you see is a bill for $1000, at $500/hour.

You would be asking what goes into that hourly rate.

Try to open auto shop (it is painful but doable) and hospital. I bet issue lies in that difference.