Ambulance chaser here. The most common reasons I don’t offer evidence of bills in a trial are that Medicaid paid the bill for pennies on the dollar, or the hospital wrote off the bills.

In many jurisdictions, if the Plaintiff chooses to introduce evidence of bills, they can only submit the amount still owed or actually paid to satisfy the bill, and the amount that was written off or contractually adjusted stays out.

Often, Medicaid may pay $700 on a $15,000 bill. Since the size of the bills tend to frame the non-economic damages (pain & suffering) awarded by juries, Plaintiffs’ attorneys don’t want small bill numbers to influence the juries into a minimal award. So, they just don’t introduce evidence of bills and hope that juries assume big bills or base their award on something else.