Even MD doctors jack up prices. For example, why does it cost $8,000-$9,000 for cash patients to get weight loss surgery but if you have insurance, they greatly increase their charge. They charged my insurance almost $90,000. My insurance almost didn't cover it. I was looking at the charges. For every pill they gave me, they charged almost $150. Which was many since I was in the hospital for 4-5 days. Blood panels cost almost $2,000. I couldn't believe how they could get away with charging insurance companies that much.

So I do believe a vet would do the same, especially for cosmetic.