Hospital bills could soar warn insurers who say doctors are set to copy America fee structures and charge four times as much for some operations.

The claim, made in a full-page advert in today's Royal Gazette, is the latest in a public spat over the introduction of new fees by insurers which doctors say will cut their income.

The two sides have been negotiating for years on updating scales until the Health Insurance Association of Bermuda (HIAB) lost patience and introduced a new scale.

HIAB says the doctors are sticking to the antiquated old scale but recommending a Miami-based fee structure for new procedure which are not covered.

The advert says: "This fee schedule could result in fees that are two to three times higher than typical Bermuda-based fees."

The insurers say a hysterectomy which cost $924 under the old schedule would cost $1,185 under the new schedule but under the Miami-based schedule would rise to $4,238.

The advert said balances not covered by insurers would be billed to patients and it points out that doctors cannot charge what they like for hospital services but must stick to the Government fee schedule.

The advert says the HIAB expect the current impasse to be resolved in the coming weeks and urged further talks with government and doctors.

Government is looking at legal remedies to stop patients bearing the brunt of the row.