$500 for a nurse to pass a sandwich? The extravagant waste in our health system

Over the course of my life, I have seen basic office procedures increasingly move to hospital-only settings.
Personally, I recall having a sigmoidoscopy in the gastroenterologist’s rooms.
In my earlier days as a GP, I was aware of female patients who received cystoscopies in the urologist’s office, and male patients who received vasectomies in his rooms.
Patients who did not have private insurance had necessary investigations and minor procedures done at minimal cost.