There's no way a 5 day hospital stay in Bali (excluding surgery) costs $22,000. That sounds way too crazy. No way the locals can pay for something like that.
The locals in the US can't afford the full-charge rate for hospital care, either. That doesn't stop it from being the rate actually billed before any discounts the particular patient may be qualified for, and, as such, the rate charged to someone who has the misfortune of not being qualified for any discounts.