This is the big reason we opted out of Medicare. We have been told that by participating in Medicare, we agreed to charge them our lowest fee. Needless to say, they don't pay what we charged, but we had to charge them our lowest, and we could not discount anyone, even those uninsured or with low income. Charging anyone less was considered fraud, and one Anchorage physician was actually prosecuted for this several years ago. It will also depend on the specifics of any contracts that might be worded similarly if you have any.
There may be issues of skewing your "usual and customary" fee if a third party payor is involved as well.
