Medical bureaucracy/EHR stuff in the US insane and I'm sure exists simply to make people even more money. These numbers probably aren't what people see in their IRL billed experience, but due to how it's all accounted for with insurance etc, these numbers probably do move between accounts in some kinda double entry manner. That 11k-15k is probably taken from some database / spreadsheet where it's all the underlying billable items between providers etc.