Why are my out of pocket expenses keep going up and up?

I am Pre-op. Why do Dr's charge a cash fee up front even though you have ins that will pay for surgery. Called PSY doc for PSY esam and as soon as I mentioned that I wanted the exam for WLS she auto said you must first pay $500 before appt. This dr on my PPO list to go to and my co-pay is $15 for appt. So why is PSY dr ($500) and WLS dr ($600) also charging up front cash before surgery? Out of pocket expenses keep going up and up. I do not understand, pls someone expain to me. What's Up?

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