Working in a physician office I can tell you reimbursement is down from insurance companies pretty much across the board and considering nothing else is going down, they do have expenses as well as their "paycheck". In this case I would say it's a matter of increasing their fee so they can charge a bigger usual and customary fee to the insurance company (which will get sliced hugely, probably back down to where it would be before they increased their fee). I would guess they aren't seeing a whole lot out of their increase.