I think the prices are simply a question of quantity and negotiation. If we see the enormous large volumes that VA is buying, then they have a very good bargaining chip to push the price down. They probably come very close to the manufacturing costs. Nevertheless, it is still interesting for the manufacturer. In comparison, an Audi in a retail store has very poor options.
I ordered my HAs on the internet and still only paid about half the usual price of local suppliers.
I have a good contact with a local Audi and showed him my invoice. He told me he was paying more at Phonak than I was paying.
For repairs, I can bring him my devices to send them to Phonak for repairs. Phonak charges a fixed price of CH 200 (approx. US$ 220). The devices are normally replaced.
So I assume that the manufacturing costs are a lot lower.
@RobHooft : In case you don’t know. The insurance (IV) pays for the repairs. (surprisingly?) 200 CHF per year per device.
You can generally look up audiologist salary ranges online. They tend to make the least of all the doctoring professions.
Here’s a pretty decent source: https://research.com/careers/highest-paying-medical-jobs#:~:text=1.,doctors%20are%20physicians%20and%20surgeons.
I was surprised at how low the average was. I would have thought it would have been more comparable to what optometrists make as they both face similar competition pressures. I’m sure there is a lot of individual variation.
I believe that the industry is set up with the hearing aid provider as client.
I have approached head office of my HA manufacturer personally; their office is about 3 miles from where I am currently. They would not respond to me on phone or when I showed up with questions. Clearly I’m not the client.
Just my thought…I’m in Canada. Other nations may be different.
It’s the same problem in the food industry. Ever tried to take a bruised apple back to the orchard? These companies simply refuse to accept their responsibilities.
Well put Dusty
Car industry too…
Yes, optometry is the obvious comparison. I wonder what the difference is. 
I think that the difference is the “smarts” are built into the hearing aids, but they need to be configured properly for them to work.
Mine are working so much better now. Difference is the setup.
RE amplification over 8K…IMHO, when amp levels get so high, it becomes painful because the ear can’t hear it but the sound pressure is still there hitting your bones. It happens to me when I take a hearing test and they crank the volume at the higher freq that I am basically deaf at.
That’s a very informative spread sheet. Thanks for the link.
Unfortunately, I’m sure that while the “no amplification above 8KHz” works for the majority of hearing aid users, it’s a bit of a middle finger to those of us with reverse slope hearing loss. I can actually hear high pitched noises better without my hearing aids.
It’s also why I’m disappointed with the decision of ASHA using an audio codec that maxes out at 7KHz (G.722). It makes music annoyingly muffled for me.
A couple of thoughts: 1) Not sure what kind of domes or molds you use, but a more open fit might allow more natural highs to come through. 2) Fitting a reverse slope is a tricky balancing act between giving you enough low frequencies to be useful without overwhelming your high frequencies by masking them.