It may vary from scenario to scenario but in general it is probably going to fall to you in situations like out-of-network lab. They don't HAVE to send things to your lab of choice, you have to ask for script to go where works for you if their default doesn't. I suppose you might have recourse with something really egregious but in general it seems to be too bad, so sad.

My OBGYN sent a bunch of labwork to an out of network lab back when I had a high deductible plan. Got a bill for 3k. Ouch. I was able to get a lot of it reduced but I still had to pay over $400 for basic labs.

Just curious about your experience. I've read some posters saying for major stuff like not getting IVF pre-authorization from insurance their clinics absorbed the cost. I am curious for smaller stuff like sending the labs to the wrong lab (not the one your insurance requires) which results in a higher charge than in-network, messing up prescription so you have to buy out of pocket in a pinch, and similar mishaps due to lower level staff being tools - do you just smile and pay up? Or complain? Is any compensation ever volunteered or you had to haggle, and if so, with whom? Fin councelor, your nurse, anyone else?