People without health insurance not only have to pay themselves, they often pay higher rates than the insured. And there's really no way to know exactly what a procedure will cost.

But there's a push to change that and to make costs more transparent and fair.

Last October, David Congero of Palm Coast went to the hospital for two outpatient procedures on his heart. He was there for a total of 14 hours. A week later he got the bill.

"My heart races, my blood pounds, my head explodes and I'm furious," said Congero.

Like millions of other Americans, Congero does not have medical insurance.

"I get a bill for $22,000 and then a second bill for $25,000," said Congero.

Congero discovered if he had insurance, his bill would have been one-seventh of what he was charged.

"Blue Cross Blue Shield, for the same procedures would have paid $3,166," he said.

Becky Cherney is president of the Florida Health Care Coalition, a group that negotiates healthcare insurance for some of Central Florida's largest employers.

"They always say there are two things you should never see made: sausage and legislation. You can add a third, healthcare billing, because there is no one in my sphere of influence could ever explain what's done there," she said.

Cherney says insurance companies dictate to hospitals what they will pay for medical procedures. If the hospital would ordinarily charge $22,000 for a catheterization, the insurance companies might pay only $3000, take it or leave it.

So, hospital costs become a hodge-podge with charges varying from one hospital to another from city-to-city and state-to-state.

An Iowa senator found out that heart surgery costs in Miami are more than 200 percent higher than the same procedure in Des Moines.

Charles Grassley is calling for relatively uniform rates for procedures, with slight variations for cost of living allowances. Grassley calls it "transparency.

Many people, including Cherney's group, feel Grassley is on to something. His "transparency" plan, they insist, will get costs in line, eliminate waste, and make payments fair for all patients, not just ones whose insurance companies foot the bill.