And all of that collective real cost to administer is a tiny fraction of what an American would pay not only out of pocket, but also the monthly premiums both they and their employer pay to the insurance company. Who will initially deny the claim just as a matter of policy, regardless of whether it's covered or submitted correctly.
Then they will deny again because the ID code they used to bill it isn't "right" or it supposedly falls into some bullshit loophole documented nowhere. So both the patient and doctor's staff have to spend dozens of hours collectively wasting their time fighting to get something simple actually handled like it should be.