US cities pay too much for buses

Well, there is your answer. The one making the purchase isn't the one primarily paying for the purchase. This makes them less sensitive to pricing.

Kinda like how expensive healthcare is since it is paid for by insurance.

Or how you don't care how much you put on your plate or what you choose to eat at an all you can eat buffet.

The second you detach the consumer from the price of something, even through an intermediary such as health insurance, that is when they stop caring about how much something costs, and so the price jumps.

The problem is that literally nobody can tell me how much anything is going to cost until I get the bill in a month. Not even because they don't want to tell me. Nobody at the desk even knows what my price is going to be because it's all numberwang.

I could be misinformed but I feel like there are only a few possible combinations of one’s actual coverage.

A simple spreadsheet could easily track everything. The providers even know how much they get from each company, so they know the allowed in-network cost for a patient.

It’s just utter laziness and stupidity.