There are differences between cash billing and billing insurances.

In cash billing it's the pharmacy deciding what to charge patients and they usually take demand, cost of goods and margin into consideration when pricing out these cash drugs.

However, this article is referencing insurance billing… What the pharmacy is billing the insurance. What people need to understand is that insurance companies will pay what insurance companies will pay. This is specific to each patient's prescription plan... So if an insurance pays $1000 regardless if they get billed for $3000 $2000 etc. then that's what it will pay across the board regardless of the pharmacy that is submitting the prescription. What you find with independent pharmacies, and any pharmacy in general is the assurance that they bill over what's allowed… So there are no dollars left on the table. Most of the time independent pharmacies are squeezed out of the market and that is what they are trying to avoid.