You do realize that a copay is called a copay because it's only a part of what he will be paid, yes? So if he bills $200 and you pay a $25 copay, insurance then pays $175 (or whatever the "allowed amount" is, which is often lower, but not by a whole lot). Copays are only a small part of the financial compensation for appointments. Not saying he is doing it for the money, just clarifying that every time you see him he has a heftier financial incentive than whatever your copay is.