Here's a better analogy. You go to McDonalds and there is no menu. They tell you.
"Just order what you want and we'll send you a bill." You go home and a month later, you get a bill for $400. You call the complaint line, wait on hold for an hour, then finally reach someone. They tell you that if your fast-food insurance was in-network, the bill would have been reduced to $200, and the insurance company would have picked up the next $100, so your bill would have only been $100, but this particular McDonalds was out-of-network, so you owe the entire $400, but that's fine because the $400 will be applied to your $10,000 out-of-networkd deductible.
Exactly! But you are missing the whole pharmaceutical game...